Value of Barium Swallow?

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Veteran Member

Date Joined Oct 2009
Total Posts : 739
   Posted 7/16/2011 6:17 AM (GMT -6)   
HI all,

I just looked over my most recent test results again from a few months ago. My endoscopy came back normal save for an irregular z line and a hiatal hernia (no esophagitis was found, even after my worst year by far of symptoms).

Yet my barium swallow of the same time showed "spontaneous GERD up to the clavicle" and dysmotility. So my question valuable is the Barium swallow as a tool? I mean, if it is showing spontaneous GERD all the way to my clavicle, why was there no esophagitis on my endoscopy?

Just trying to put it all together to see what it means. Thanks,

Elite Member

Date Joined Apr 2007
Total Posts : 32602
   Posted 7/16/2011 7:59 AM (GMT -6)   
To the best of my knowledge this test is not sensitive enough to be used as a reliable diagnostic test for GERD. It is used more often in patients who are experiencing difficulty with swallowing. The upper endoscopy is more accurate then the Barium  Swallow.
I would discuss your concerns with your Dr.

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Forum Moderator

Date Joined Feb 2009
Total Posts : 7188
   Posted 7/16/2011 8:17 AM (GMT -6)   

I've had several barium swallows, and they aren't very sensitive to small things, but seem to catch big issues instead. In my experience there's more of a risk for false negatives, rather than false positives. You can be having mild reflux, but if your LES is not wide open, it's not likely to show anything.

As far as what you're described, I would guess that you're getting plenty of reflux, but I assume you're on PPI's. If that's the case, then the PPI's are protecting your esophagus and keeping the esophagitis at bay. (That was generally my situation. I did get esophagitis from time to time, but my esophagus was always healthy during endoscopies and biopsies. Thankfully.)

I'm no expert, but that would be my take.
Good luck!

Veteran Member

Date Joined Oct 2009
Total Posts : 5028
   Posted 7/16/2011 1:12 PM (GMT -6)   
Barium swallow can catch the reflux when it's happening and also show swallowing anomalies/dysmotility - all of which endoscopy can't do. It's another, different, valuable tool.

Denise is right. If the PPIs are working you may not have esophageal damage that can be seen from the inside. I didn't either.

What the tests mostly don't show, unless there is an obvious wide open LES or paraesophageal hernia, is the cause of the reflux.

mock turtle
Regular Member

Date Joined Mar 2011
Total Posts : 467
   Posted 7/16/2011 1:58 PM (GMT -6)   
my barium swallow came up normal and as problems persisted, "we", i, had to go thru other more "telling" tests

considering the radiation exposure involved with the and that endoscopy , ph and manometry testing are "waiting in the wings" as the next test after barium swallow, id have preferred to just go for the gold standard right away and skip the barium swallow test which after all is all about fluoroscopy

in the last year have been ct scanned twice chest xrayed 8 times and fluoroscoped once, on the operating table IVP and other radiation ..... and so.... ive told my docs from now on, or until the unforeseeable future, its ultra sound and or MRI for me because ive had more than enough radiation exposure , thank you very much ( too many docs ive met are cavalier about my concerns with radiation and imaging)

yes the barium swallow gives us a movie and shows motility but then what?

its still popping antacid pills, and or PPIs and or H2s and or surgery down the road and for me at least the barium swallow was of very limited value

for some who have reason to believe that esophageal peristalsis is an issue then i can see where the barium swallow would make sense

mock turtle
Regular Member

Date Joined Mar 2011
Total Posts : 467
   Posted 7/16/2011 2:08 PM (GMT -6)   
yes i realize im being overly reactive to the radiation risk and the comparative risk numbers for airline travel, background radiation etc, not to mention crossing the street are significant...just me


heres a good cite to calculate medical imaging radiation exposure

Regular Member

Date Joined Dec 2009
Total Posts : 293
   Posted 7/17/2011 5:45 PM (GMT -6)   
same problem. one day my barium is normal, next days shows reflux to clavicle spontaneously. i thinkk for lpr it shows we have something going on, but i personally thing the test is generally a waste. fundo no help, acid pills no help. both together no help. one of 2 things we are still getting enough acid to prevent healing in larynx as it is more sensitive than esophogus or we are getting pepsin or something. atypical symptoms are almost impossible to fix some say fundo helps but more say it does not it did not for me 2 ppis, h2 blocker eating plain bread, losing 30 lbs and fundo. tried all the old wives tales nothing. we need to find someone to think outside of the box becUSE THE DOCS/SURGEONS DONT. WE ARE LACKING A PROTECTIVE BARRIER AND SOMETHING IS CAUSING THE DAMAGE OTHER THAN ACID. sorry for caps accident we need to keep lloking nobody understands our burned throats they say acid, i dont buty it i have done everything possible to stop acid im asking if a feeding tube would prevent all reflux to throat. i want a biopsy of larynx to check for pepsin or something

Veteran Member

Date Joined Oct 2009
Total Posts : 739
   Posted 7/18/2011 1:30 PM (GMT -6)   
@ JOE,

Very similar to my story. Are they sure yours is reflux, do you have Barrets? Tell me more...I also get no relief from nothing but am not a candidate for surgery since I have atypical symtoms and dysmotility.
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