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Upper GI Series / Small Bowel Follow-through (UGI/SI)

What is an Upper GI Series?

This test uses a type of X-ray technology called a fluoroscope to take moving pictures of your child’s digestive tract. We will administer a contrast agent to highlight the structure of your child's esophagus, stomach and small intestine. This test will show us how well they are functioning.

An Upper GI series may be ordered to diagnose or evaluate children with a persistent cough, difficulty swallowing, vomiting, abdominal pain, and suspected gastroesophageal reflux (GERD).

Before the exam, your child will drink a liquid contract agent containing barium. This tastes like a thick, milkshake and is available in several flavors.

During the exam your child will be asked to lie on a table below the fluoroscope.

What is a Small Bowel Follow-through?

A Small Bowel Follow-through is uses the same technology to assess the second and third sections of the small intestine (the jejunum and the ileum).

This test is ordered to assess children suffering from abdominal pain, diarrhea, and those who are failing to grow properly. It is also used to check for Crohn’s disease.

How should I help my child get ready for these tests?

Your child’s stomach should be empty before the imaging test, so that the doctor can obtain the clearest, most useful images.

  • If your child is under 6 months old: do not feed anything within two hours of the exam.
  • If your child is over 6 months: do not feed anything for four hours before the exam.

On the day of the test, be sure your child is dressed in comfortable clothing. He or she may be asked to change into a gown before the exam begins.

What will happen during the tests?

For the upper GI series: your child will lie down on the side or back, then consume the barium milkshake from a bottle or a cup. As the contrast agent moves through the digestive tract and enters the small intestine, the radiologist will take pictures of this area from several angles.

The test takes from 5 to 30 minutes, depending on how quickly the contrast agent passes through your child’s system.

Once it is completed, we can perform the small bowel series, if this is also indicated.

Your child will drink more of the milkshake, then come back to the fluoroscopy area every 20-30 minutes for additional pictures, as the contrast travels through the GI tract. This test can take several hours to complete.

Sometimes a Small Bowel Follow-Up may also be performed alone, without the Upper GI series. In this case, your child will drink a cup of contrast agent in the waiting room, then come back to the fluoroscopy area for imaging every 20 or 30 minutes.

How can I make my child comfortable during the test?

Young children sometimes find the fluoroscope, a large machine that passes over the X-ray table, a bit intimidating. Sometimes we may also need to immobilize young patients so we can position them properly. If needed, we will wrap your child's legs with an ace bandage and ask you to hold their hands during the procedure to keep them from fidgeting.

You can remain in the exam room throughout this test to provide comfort and reassurance. If so, you will be given a lead apron to protect against unnecessary radiation.

We can also ask a child life specialist to be present, to help put your child at ease during the procedure.

Are there any risks?

This exam uses X-ray based diagnostic radiation, however your child will be exposed to minimal doses.

What happens after the test

Your child can resume normal activities immediately. But since barium may cause constipation, be sure your child drinks extra fluids for the rest of the day. 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 your child’s physician will explain the results.