Upper GI Series With Small Bowel Follow Through 

What is an upper GI series with small bowel follow through?

An upper GI series with small bowel follow through is an imaging study that helps us evaluate  your child’s esophagus, stomach, and entire small intestine. We use this test to evaluate children who have abdominal pain, diarrhea, and who are failing to grow properly. It may be used to make the diagnosis of Crohn’s disease.

This is a fluoroscopy exam. This type of X-ray imaging enables us to capture a real-time, moving image of your child swallowing and digesting, much like an X-ray movie. To make this image we use a specialized X-ray machine called a fluoroscope. We will ask your child to drink a liquid contrast agent to make their digestive system show up on the image.

How can I help my child prepare for the exam?

Your child’s stomach should be empty so that we can obtain the clearest, most useful images:

  • If your child is under six months of age do not feed them anything within two hours of the exam.
  • If your child is over six months of age do not feed them anything for four hours before the exam.

Your child should wear comfortable clothes on the day of the appointment. Please make childcare arrangements for siblings as they will not be allowed into the exam room.

Please note that if you are pregnant, you will not be allowed in the room during the exam and may wish to make arrangements to have someone else be with your child.

What will happen during the exam?

Your child will be asked to change into a gown when you arrive for your appointment. The technologist will bring you and your child to the exam room and explain the procedure. You will also meet the radiologist who will be taking the pictures.

The exam has two parts. For the upper GI series, we will ask your child to lie on a table below the fluoroscope machine. We'll ask them to swallow a barium contrast liquid from a bottle or cup. As the contrast passes from the mouth to the stomach to the small intestine, the radiologist will take pictures of the organs from different angles. We'll ask your child to move to different positions to help us get the right images. This exam takes between 5 to 30 minutes, depending on how quickly the contrast passes through your child’s system.

We can perform the small bowel follow through immediately after the completion of the upper GI series. We will ask your child to drink more barium contrast. The technologist will then take periodic X-ray images as the contrast travels through the GI tract. This test may take several hours to complete.

Sometimes, we do a small bowel series without the upper GI series. The technologist will ask your child to drink a cup of barium contrast liquid in the waiting room. We will then bring them into the fluoroscopy area for imaging every 20 or 30 minutes as the contrast travels through the GI tract. This test may take several hours to complete.

How can I help my child feel comfortable during the exam?

Young children sometimes find the fluoroscope a bit frightening. You can remain with your child in the imaging area during the exam to offer comfort and reassurance. You will be asked to wear a lead apron to protect you from unnecessary exposure to radiation. We can also arrange to have a child life specialist at your child's appointment to help your child better cope with the stress of the procedure.

Are there any risks?

This is an X-ray based exam and your child will be exposed to minimal doses of diagnostic radiation. We adjust the dose of radiation to the size of your child. The risk is small compared to the benefit of an accurate diagnosis or intervention.

After the exam

Your child can immediately resume normal activities after their exam. Because barium may cause constipation, it's important to have them drink extra fluid after the exam. Your child’s first bowel movement may be white or gray because of the barium. This is normal!

A radiologist will analyze the images and share the results with the doctor who requested the exam, who will then discuss the results with you.