Barium Swallow Test

Those of you who have been around these parts for a while will know that I’ve been having some problems with dysphagia symptoms. To determine the cause of these symptoms, I’ve have Oesophageal Physiology tests (comprises of two tests), a gastroscopy and a Barium Swallow test. I’ve shared my experience of the first three tests, so I thought it only right that I share my experience of the fourth – the Barium Swallow test.

My barium swallow test was scheduled for 2pm. When I received the paperwork for it, I found out that I wasn’t allowed to eat or drink after 7am. This immediately rang alarm bells for me. I need to drink water regularly to help manage my PoTS symptoms. My basilar type and hemiplegic migraine are adversely affected by not being able to eat regularly. The information I received advised that insulin dependent diabetics should contact the clinic if they receive an afternoon appointment. Because of this, I decided that it would be worth phoning the clinic to discuss my need to eat and drink regularly.

The lady I spoke to was very understanding. She advised me it would be ok to drink water throughout the day of my Barium Swallow test. However, the 7am restriction on eating was to remain in place. I found this really difficult to get my head around. I can understand not eating for a certain period of time. However, if my appointment had been at 11am, I’d only have had to go without food for 4 hours. So why I couldn’t eat until 10am, I really don’t know. Unfortunately, there was a problem with patient transport. So I didn’t arrive at the hospital until gone 4pm. I was grouchy, exhausted and had a bad migraine, having not been able to eat all day.

If not being able to eat or drink adversely affects your health, what ever tests you are due to have, please call the department and talk to them about your personal difficulties. They will be able to advise you in relation to your specific condition and test.

When I turned up at the department for my Barium Swallow test, the staff were lovely. I’d phoned ahead to let them know of the transport difficulties and they were very accommodating. I was taken to an area with a row of cubicles to put on a gown. The nurse checked there was enough room for my wheelchair and asked if I needed any help, before leaving me to change. I was told to remove my jumper and bra, but that it was ok to keep my t-shirt on. Because the test involves and x-ray, I’d thought ahead and wore a cropped top without wires. This meant that I didn’t have to go completely braless. I’m sure other larger busted ladies will understand why this was so important.

While changing, I realised I couldn’t tie the gown behind myself safely. I waited for the nurse to return and asked her to help me. To my surprise the nurse replied to my request for help with “Sure, you don’t want to dislocate something!” I wasn’t sure whether she was being flippant, until she told me I was the third lady they had seen that month with EDS. This wasn’t what I was expecting at all. Not only had this nurse heard of EDS, she had read my notes and knew my conditions without me having to tell her! Wow. I wish all medical professionals were as on-the-ball as she was.

I was taken into the room where the Barrium Swallow test was to be performed and introduced to the technician. He explained what the test entailed. Because the test involves an amount of standing, he asked me about my ability to do this. I can stand for a few minutes, but after that it becomes very painful and very difficult. Having not been able to eat wasn’t going to help as by this time I was feeling rather dizzy. Because of the risk of subluxation (EDS) and fainting (PoTS), the technician decided to have me in a standing position, but slightly reclined.

The machine itself consists of an examination style bed, with a board on one end to stand on. At the start of the test, this bed is vertical and I was stood up against it. The nurse added two handles for me to hold onto, both to help me get onto the board and to help me stay upright. The technician then reclined the bed slightly to take some of the weight off my knees and hips. I’m really glad that he did this for me, because even with the slight recline, my left leg kept giving way throughout the test.

The second part of the machine consisted of the x-ray section. A plate on the end of what I can only describe as an arm, that moved to capture different angles. There was also a screen that showed the x-ray pictures in real time. It was really interesting to watch this as the test took place.

During the Barium Swallow test, I had to swallow some liquid at various different times. The technician then took different images to see how the liquid was passing down my oesophagus and into my stomach. These tests were carried out both in a stood up position and lying down, in order to remove the element of gravity. At one point, I also had to swallow some powder followed by a fizzy clear liquid. This was to fill my stomach with gas in order to see more clearly what was happening.

The Barium Swallow test itself was painless and relatively quick. I had some difficulty when the bed was raised from a lying position, because of my PoTS. The movement was very similar to that of a tilt table test. I had warned the technician that moving me from lying down to an upright position too quickly would cause autonomic symptoms. The nurse noticed that I was having problems and asked me if I was ok. On hearing this, the technician immediately lowered the bed. to a horizontal position. He allowed me to recover, before raising the bed more slowly and in steps.

The staff performing my Barium Swallow test were absolutely fantastic and took such great care of me. The nurse was constantly making sure that I was ok and comfortable and the technician made the test as easy as possible. Other than tilting me up too quickly, he did everything possible to make adapt the test for my needs. I think sometimes it can be hard for people who haven’t experienced a condition to understand how little is needed to exacerbate symptoms. With the care the technician had taken with everything else, I’m sure that he thought he was raising the table slowly enough (until he saw me woozy) and he reacted in exactly the right way.

Something I think worth mentioning about the Barium Swallow test, is that the information I received stated that the liquid that I would need to swallow could cause constipation and advised taking a laxative before the test. I experienced no such problem, so would advise people to have a laxative on hand should it be needed, but not to take it preemptively.

If you need to have a Barium swallow test and are unable to stand for approximately 10 minutes, I would suggest contacting the department to discuss with them how they can adapt the test for you. I didn’t do this, as I was not aware that the test would involve standing. I was lucky that I had a caring team who were able to adapt.

UPDATE: I have been diagnosed with oesophageal dysmotility.

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