How to make a barium swallow test a little easier | Actions that really help technicians and actions that cause trouble
Introduction
"I've heard barium tests are painful, will I be okay?"
"I don't think I can hold back my burps."
"I'm scared because I don't know what they're going to do to me."
Many of you reading this article likely have these concerns.
In reality, a barium swallow test (upper GI series) is difficult to visualize, especially for first-timers.
As a radiological technologist, I am involved in upper GI series examinations every day.
What I feel during these exams is,
that even for the same test, there are people who found it "easier than expected" and people who found it "quite difficult."
That is the case.
However, that is not a difference in endurance.
In many cases,
it is a difference in "whether you knew beforehand."
That is the difference.
What I actually hear often from patients is,
"I wish I had known sooner."
"It would have been different if I had known what was going to happen."
"It was busier than I imagined."
These are the voices I hear.
In this article,
・Preparations you should make the day before
・What happens with the effervescent agent and barium
・What actually happens on the examination table
I will summarize these from the perspective of someone on the front lines.
By the time you finish reading this,
the anxiety of "not knowing what will be done to you"
should be reduced a little.
Chapter 1: "It's almost decided the day before" Preparations you should make before the exam
The reason not to take dietary restrictions the day before lightly
A stomach fluoroscopy involves coating the inside of the stomach with barium for imaging.
In other words,
if food remains in the stomach, it becomes difficult to see
that is what it means.
In actual practice,
・Ate a little late at night
・Thought a candy would be fine
・Only drank coffee in the morning
These cases are not rare.
Even if there is a lesion in the stomach,
it may be obscured by food residue, making it hard to see
and this can happen.
"There is a shadow, but I can't tell if it's food or a disease, so let's do a re-examination"—this is the biggest disadvantage for the patient.
The dietary restrictions in the instructions are more important than you might think.
Even if it feels a bit strict, following them will make things go more smoothly in the end.
Surprisingly common misunderstandings about water, medication, and smoking
This is where many questions arise.
“Can I drink water?”
“What about my usual medication?”
“Is just one cigarette okay?”
The hospital's instructions are the top priority, but one thing that can be said in common is,
“It is safer not to make your own judgment”
is the point.
Especially,
“I was thirsty so I drank a little water”
is one such case.
While a small amount may not be a problem, water consumed right before the test can remain in the stomach.
Then,
the barium may become diluted and fail to adhere properly to the stomach wall. When looking at the images on-site, there are times when the difference in the image quality is so clear that we can tell, 'Ah, they drank water earlier.'
Common 'pre-test' issues that trouble technicians
What troubles the technicians is,
・Violations of dietary restrictions discovered at the last minute
・Important information (such as surgical history) revealed late
・Enduring constipation or feeling unwell without saying anything
These are such cases.
Conversely, what helps is,
“I accidentally ate a little yesterday”
“Actually, I tend to choke easily.”
Please tell us this early on.
Rather than hiding it, telling us beforehand makes it easier for us to respond, such as by adjusting the order of the imaging or providing more careful assistance.
Morning-of checklist
□ Followed dietary restrictions
□ Checked medications
□ Confirmed fluid restrictions
□ Ready to communicate concerns about swallowing
If you have prepared this much, you are all set.
Chapter 2: “I feel like I might burp...” The story of effervescent agents and barium
This is probably the part people are most concerned about.
The most common question from patients is,
“Is the effervescent agent painful?”
To be honest,
there are people who find it uncomfortable.
However,
people who know what is going to happen tend to be able to receive it more calmly.
That is my impression.
Why you need to hold back burps
The effervescent agent is used to inflate the stomach.
It is hard to see the surface of a deflated balloon,
but if you inflate it until it is taut, you can even see the wrinkles clearly, right?
It is the same principle.
That is why technicians desperately say,
"Please hold in your burps!"
However, from the patient's perspective,
"No, it's impossible... I feel like it's going to come out the moment I swallow..."
I understand that feeling well.
Common "Oh, it came out" patterns actually seen in the field include:
・Trying to rush and swallow the barium immediately after taking the effervescent agent, causing you to swallow air along with it
・Tensing your shoulders due to nervousness, which puts pressure on your abdomen and causes a burp
・Opening your mouth wide the moment you think "It's coming out!"
these are the patterns.
Actually, in many cases, "if only a little bit comes out, it's still okay."
If you let it all out, we have to re-inflate (add more effervescent agent), but
if only a little leaks out, we can often continue the examination as is.
Don't give up and think "It came out once, so it's over now."
Please listen to the instructions that follow.
Chapter 3: Why the "turn right, turn left" instructions come so suddenly | Why you feel rushed on the examination table
This is where we talk about the actual examination room.
A surprisingly common impression after the examination.
That is,
"It was busier than I thought"
is what they say.
During the examination,
"Please turn to the right"
“Please turn around.”
“Please hold your breath.”
“A little more to the left.”
The instructions come all at once.
As a result,
“Am I being scolded?”
“Am I being rushed?”
Some people think this.
But in most cases, that is not the case.
The reason is simple.
Because barium flows over time.
Furthermore, in younger people,
gastric mucus can increase over time, which can easily dilute the barium.
In other words,
it is a race against time.
That is why the technician is,
not thinking,
“I want to finish this quickly,”
but rather,
“I want to take the pictures while the condition is good.”
is what I think.
Just knowing this much,
will reduce some of the anxiety during the exam.
Having read this far,
you might be thinking,
“So how should I actually move?”
“What should I actually do to prevent burping?”
Actually,
there are tricks to how you move on the examination table and how to manage burping.
In the next section,
• How to relax to make the exam easier • Movements that make technicians think, “This person is used to this” • Secret tricks veteran patients use to release burps • The real story about laxatives and the restroom afterward
I will write about these in quite specific detail.