Part 6 · Gastrointestinal and Hepatobiliary Imaging

77. GI Contrast Studies and the Oesophagus

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Study	Indication	Notes
Barium swallow (± video fluoroscopy)	dysphagia, odynophagia, motility, web, diverticulum	modified barium swallow (speech therapy) for aspiration
Water‑soluble swallow	suspected perforation (Boerhaave) or anastomotic leak	low‑osmolar if aspiration risk
Barium meal	largely replaced by endoscopy	double contrast with effervescent granules
Follow‑through / enteroclysis	small bowel (Crohn's, TB, malabsorption)	largely replaced by CT/MR enterography and capsule endoscopy
Barium / CT colonography	colon screening when colonoscopy incomplete/contraindicated	CT colonography is preferred
Distal loopogram	integrity of distal bowel/anastomosis before stoma closure	water‑soluble
Defecating proctogram	evacuation disorders, rectocele, intussusception	MR defecography alternative
Fistulogram	fistula tracts	MRI = IOC for fistula‑in‑ano (Parks/St James's classification)

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Study

Indication

Notes

Barium swallow (± video fluoroscopy)

dysphagia, odynophagia, motility, web, diverticulum

modified barium swallow (speech therapy) for aspiration

Water‑soluble swallow

suspected perforation (Boerhaave) or anastomotic leak

low‑osmolar if aspiration risk

Barium meal

largely replaced by endoscopy

double contrast with effervescent granules

Follow‑through / enteroclysis

small bowel (Crohn's, TB, malabsorption)

largely replaced by CT/MR enterography and capsule endoscopy

Barium / CT colonography

colon screening when colonoscopy incomplete/contraindicated

CT colonography is preferred

Distal loopogram

integrity of distal bowel/anastomosis before stoma closure

water‑soluble

Defecating proctogram

evacuation disorders, rectocele, intussusception

MR defecography alternative

Fistulogram

fistula tracts

MRI = IOC for fistula‑in‑ano (Parks/St James's classification)