What is Upper Gastrointestinal (GI) Tract Radiography?
Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum) that uses a special form of x-ray called fluoroscopy and an orally ingested contrast material called barium.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.
An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow.
In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
What are some common uses of the procedure?
An upper GI examination helps evaluate digestive function and to detect:
- ulcers
- tumors
- inflammation of the esophagus, stomach and duodenum
- hiatal hernias
- scarring
- blockages
- abnormalities of the muscular wall of GI tissues
The procedure is also used to help diagnose symptoms such as:
- difficulty swallowing
- chest and abdominal pain
- reflux (a backward flow of partially digested food and digestive juices), also known as gerd
- unexplained vomiting
- severe indigestion
- blood in the stool (indicating internal GI bleeding)
Additional Resources
Frequently Asked Questions
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How does the procedure work?
Fluoroscopy uses a continuous x-ray beam to create a sequence of images that are projected onto a television-like monitor. When used with a contrast material, it clearly defines the area being examined by making it appear bright white.
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How is the procedure performed?
This examination is usually performed on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
A radiologic technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the upper GI series. As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient's digestive tract on a fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review. The patient must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image.
For a double-contrast upper GI series, the patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken. When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. This exam is usually completed within 20 minutes.
Neil A. Ramquist, MD
Diagnostic Radiologist
- Head of Diagnostic Radiology at Rex Hospital
- BS, MD, University of California at Davis
- Chief resident in radiology, Bowman Gray School of Medicine
- Member, American College of Radiology
- Member, Radiological Society of North America
- Native of Wisconsin
Expertise in mammography, CT, and ultrasound
Joined Raleigh Radiology in 1981
Donald G. Detweiler, MD
Diagnostic Radiologist
- President, Raleigh Radiology Associates
- Medical Director, Raleigh Radiology Blue Ridge, Cary and Breast Center
- Chairman, Rex Classic - 2000
- President, Medical Staff Rex Hospital - 1995
- BS, Duke University
- MD, Emory University
- Fellow and resident in diagnostic radiology, University of North Carolina Medical Center
- Native of Illinois
Expertise in mammography, CT, and ultrasound
Joined Raleigh Radiology in 1982
W. Kent Davis, MD
Neuroradiologist
- Medical Director, Raleigh Radiology Cedarhurst, Clayton, Wake Forest, and Brier Creek
- BS, Duke University
- MD, University of North Carolina at Chapel Hill
- Internship in internal medicine, Union Memorial Hospital, Baltimore
- Resident in radiology, Duke University Medical Center
- Fellowship in neuroradiology, Duke University Medical Center
- Certificate of Added Qualifications in Neuroradiology awarded by American Board of Radiology
- Member, American Society of Neuroradiology
- Native of North Carolina
Expertise in head, neck, and spine imaging; breast imaging and breast intervention
Joined Raleigh Radiology in 1990
Andrew B. Weber, MD
Vascular and Interventional Radiologist
- BS, University of Pennsylvania
- MD, Temple University Medical School
- Internship in surgery, York Hospital
- Chief resident, Duke University Medical Center
- Former Chief, Rex Hospital Radiology
- 2009 Chairman, Rex Hospital Open
- Rex Corporate Counsel
- Native of Pennsylvania
Expertise in vascular/interventional radiology and MR angiography
Joined Raleigh Radiology in 1992
Mark H. Knelson, MD
Vascular and Interventional Radiologist
- BS, MD, University of North Carolina at Chapel Hill
- Rotating internship, Case Western Reserve University Hospitals of Cleveland
- Chief resident, Case Western Reserve University Hospitals of Cleveland
- Fellowship, vascular and interventional radiology, Duke University Medical Center
- Certificate of Added Qualifications in Vascular and Interventional Radiology awarded
- American Board of Radiology Assistant professor of radiology, Duke University Medical Center
- Member, Society of Interventional Radiology, American College of Radiology
- Native of North Carolina
Expertise in diagnostic angiography and interventional radiology, nuclear cardiology, and spine intervention
Joined Raleigh Radiology in 1993
Julia K. Taber, MD
Women’s Imaging Radiologist
- Chief of Radiology at Rex Hospital
- BS, Brown University
- MD, Duke University Medical School
- Internship in internal medicine, New York Hospital
- Resident in diagnostic radiology, Duke University Medical Center
- Fellowship in mammography and pediatric radiology, Duke University Medical Center
- Member, Society of Breast Imaging
- Member, American Institute of Ultrasound in Medicine
- Women’s Imaging Radiologist
Expertise in breast imaging, breast intervention, and pediatric radiology
Joined Raleigh Radiology in 1993
Gregory C. Hinn, MD
Musculoskeletal Radiologist
- Head of Musculoskeletal Imaging at Rex Hospital
- BA, University of North Carolina at Chapel Hill
- MD, Bowman Gray School of Medicine at Wake Forest University
- Resident in radiology, University of Virginia Health Sciences Center
- Fellowship in diagnostic and interventional musculoskeletal radiology, University of Virginia Health Sciences Center
- Musculoskeletal radiologist for the North Carolina State University Athletic Department.
- Raised in North Carolina
Expertise in musculoskeletal imaging with bone and joint intervention
Joined Raleigh Radiology in 1995
Gregory A. Bortoff, MD, PhD
Abdominal Imaging Radiologist
- Head of Computed Tomography (CT) at Rex Hospital
- Radiologist Recruiter
- BS, Cornell University
- MD, PhD, State University of New York Health Science Center at Syracuse
- Resident in radiology, Wake Forest University Baptist Medical Center
- Fellowship in abdominal imaging, Wake Forest University Baptist Medical Center
- Member, Radiological Society of North America
- Member, American Roentgen Ray Society
- Native of New York
Expertise in abdominal imaging, including MRI, MRA, ultrasound, oncologic imaging, and PET/CT
Joined Raleigh Radiology in 1999
Jerry L. Watson, MD
Abdominal Imaging Radiologist
- BS with honors, Johns Hopkins University
- MD, University of Texas, Southwestern Medical Center at Dallas
- Resident in radiology, University of North Carolina at Chapel Hill
- Fellowship in abdominal imaging, University of North Carolina at Chapel Hill
- Chief of Radiology, 67th Combat Support Hospital, United States Army, Germany 1996–1998
- Native of Georgia
Expertise in abdominal imaging, including MRI, MRA, ultrasound, breast intervention, oncologic imaging, and PET/CT
Joined Raleigh Radiology in 1999
Cynthia S. Payne, MD
Vascular and Interventional & Neuroradiologist
- MD, Medical College of Ohio
- Internship, Mount Auburn Hospital, Harvard Medical School
- Resident, neurology and radiology, Duke University Medical Center
- Fellowships in molecular neurogenetics, vascular/interventional radiology and neuroradiology, Duke University Medical Center
- Certificate of Added Qualifications in Neuroradiology, Vascular and
- Interventional Radiology awarded by American Board of Radiology
- Director of neuro-interventional radiology, Greater Baltimore Medical Center
- Native of North Carolina
Expertise in vascular and interventional radiology, diagnostic, and interventional neuroradiology
Joined Raleigh Radiology in 2001
Tracey E. O’Connell, MD
Musculoskeletal Radiologist
- BA, University of Colorado at Boulder
- MD, University of North Carolina at Chapel Hill
- Resident in radiology, University of North Carolina at Chapel Hill
- Fellowship in musculoskeletal radiology, Duke University Medical Center
- Member, Radiological Society of North America
- Native of California
Expertise in musculoskeletal imaging with bone and joint intervention and abdominal imaging including MRI, MRA, CT, and ultrasound
Joined Raleigh Radiology in 2001
Jennifer S. Van Vickle, MD
Abdominal Imaging Radiologist
- Head of Ultrasound at Rex Hospital
- BA, University of Chicago, M.Div and Th.M, Duke University
- MD, Duke University Medical Center
- Internship in internal medicine, Duke University Medical Center
- Resident in diagnostic radiology, Duke University Medical Center
- Fellowship in abdominal imaging and mammography, Duke University Medical Center
- Native of Missouri
Expertise in breast imaging, breast intervention, abdominal and pelvic imaging, including CT, ultrasound, and MRI
Joined Raleigh Radiology in 2002
Gintaras E. Degesys, MD
Musculoskeletal Radiologist
- BA with high honors, Kenyon College
- MD, University of Cincinnati College of Medicine
- Internship and chief resident, Northwestern University
- Fellowship in interventional and abdominal imaging, Duke University Medical Center
- Certificate of Added Qualifi cations in Vascular and Interventional Radiology awarded by American Board of Radiology
- Native of Ohio
Expertise in musculoskeletal imaging, breast intervention, and abdominal imaging and intervention
Joined Raleigh Radiology in 2002
Laura O. Thomas, MD
Abdominal Imaging Radiologist
- Head of Rex Breast Care Center at Rex Hospital
- Radiologist Recruiter
- BA, Princeton University
- MD, Duke University Medical School
- Internship in internal medicine, UNC Hospitals
- Chief resident, Duke University Medical Center
- Fellowship in women’s and abdominal imaging, Duke University Medical Center
- Native of Missouri
Expertise in breast imaging, breast intervention, abdominal imaging, oncologic imaging, and PET/CT
Joined Raleigh Radiology in 2003
John G. “Jay” Alley, Jr, MD
Neuroradiologist
- Vice Chief of Radiology at Rex Hospital
- BA, University of North Carolina at Chapel Hill
- Post-Baccalaureate Premedical Program, Columbia University, New York
- MD, University of North Carolina School of Medicine
- Co-chief resident in diagnostic radiology, University of North Carolina Hospitals
- Fellowship in neuroradiology, University of North Carolina Hospitals
- Native of North Carolina
Expertise in neuroradiology
Joined Raleigh Radiology in 2004
Todd J. Roth, MD
Abdominal Imaging Radiologist
- BS, University of Texas, Austin
- MD, University of Texas Health Sciences Center, San Antonio
- Residency, Baptist Medical Center, Wake Forest University, Winston-Salem
- Fellowship in abdominal imaging, Baptist Medical Center, Wake Forest University
- Native of Kansas
Expertise in abdominal and pelvic MRI, MRA, CT, and ultrasound
Joined Raleigh Radiology in 2004
Steven R. Carter, MD
Musculoskeletal Radiologist
- BS, University of Virginia
- MS, Medical College of Virginia
- MD, Medical College of Virginia
- Internship in internal medicine, MCV
- Chief resident, diagnostic radiology, Emory University
- Fellowship in musculoskeletal imaging, Emory University
- Member, American Roentgen Ray Society, American College of Radiology, Radiological Society of North America
- Musculoskeletal radiologist for the Carolina Hurricanes
- Native of Richmond, Virginia
Expertise in musculoskeletal radiology
Joined Raleigh Radiology in 2005
Satish Mathan, MD
Vascular and Interventional Radiologist
- Head of Interventional and Vascular Radiology at Rex Hospital
- BS, University of California at Santa Barbara
- MD, Medical College of Wisconsin
- Internship, Santa Clara Valley Medical Center, San Jose, CA
- Chief resident, University of North Carolina Hospitals, Chapel Hill, NC
- Fellowship in vascular and interventional radiology, University of North Carolina Hospitals
- Member, Society of Interventional Radiology, American College of Radiology
- Native of Raleigh, North Carolina
Expertise in interventional radiology
Joined Raleigh Radiology in 2005
Andrew G. Moran, MD
Nuclear Medicine Radiologist
- Head of Nuclear Medicine Radiology at Rex Hospital
- BS, Idaho State University
- MD, Utah School of Medicine
- Residency, Duke University Medical Center
- Fellowships in body imaging and nuclear radiology, Duke University Medical Center
- Member, Society of Nuclear Medicine
- Native of California
Expertise in abdominal imaging, oncologic imaging, nuclear medicine and PET/CT
Joined Raleigh Radiology in 2006
Joshua B. Mitchell, MD
Musculoskeletal Radiologist
- BA, University of Virginia
- MD, University of Tennessee College of Medicine
- Internship, Medical University of South Carolina
- Chief resident, Medical University of South Carolina
- Fellowship in musculoskeletal radiology, University of Florida
- Member, American College of Radiology, South Carolina
- Radiological Society, Association of University Radiologists, Radiological Society of North America
- Native of Chattanooga, Tennessee
Expertise in musculoskeletal imaging
Joined Raleigh Radiology in 2007
Jeffrey Browne, MD
Musculoskeletal Radiologist
- BS, Boston College
- MD, University of Connecticut School of Medicine
- Internship, St. Raphael’s Hospital
- Residency, Duke University Medical Center
- Fellowship in musculoskeletal radiology, Duke University Medical Center
- Member, American College of Radiology, Radiological Society of North America and American Roetgen Ray Society.
- Native of Connecticut
Expertise in musculoskeletal imaging
Joined Raleigh Radiology in 2008
Michael C. Hollingshead, MD
Neuroradiologist
- Head of Neuroradiology at Rex Hospital
- BA, University of North Carolina at Chapel Hill
- MD, University of North Carolina at Chapel Hill
- Internship, University of North Carolina at Chapel Hill
- Residency, University of North Carolina at Chapel Hill
- Fellowship in neuroradiology, University of North Carolina at Chapel Hill
- Certificate of added Qualifications in Neuroradiology awarded by American Board of Radiology
- Member, American Society of Neuroradiology, American College of Radiology,Radiological Society of North America
- Native of Massachusetts
Expertise in neuroradiology
Joined Raleigh Radiology in 2008
Jason R. Harris, MD
Vascular and Interventional Radiologist
- BS, Brigham Young University
- MD, Harvard Medical School
- Internship, Newton-Wellesley Hospital, Newton, Massachusetts
- Residency, Massachusetts General Hospital, Boston, Massachusetts
- Fellowship in vascular and interventional radiology, Duke University Medical Center
- Member, American College of Radiology, Society of Interventional Radiology
- Native of California
Expertise in vascular and interventional and musculoskeletal radiology
Joined Raleigh Radiology in 2008
How should I prepare?
Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.
To ensure the best possible image quality, your stomach must be empty of food. The day before the exam remain on a clear liquid all day drinking 8 oz of water each hour. (For breakfast, lunch (noon) and dinner (5:00 pm) patient can drink sugar free drinks (no milk or creamer), clear broths, sugar free gelatin, sugar free popsicles.) The patient can pick up prep and instructions from our Blue Ridge, Cedarhurst and Cary facilities.
