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Health Information and Tools > Speech, Language and Hearing > Feeding and Swallowing >  Swallowing X-Rays: Barium and Modified Barium
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Feeding and Swallowing

Swallowing X-Rays: Barium and Modified Barium

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​​​​​What’s a barium swallow test?

A barium swallow test uses a type of x-ray (video fluoroscopy) to see what happens when people swallow a food or liquid. This test helps to see:

  • how the mouth, throat, and the swallowing tube (esophagus) work while you’re swallowing
  • if there’s a swallowing problem
  • what might help to make the swallow better

Barium is a chalky-tasting material that’s mixed with food or liquid for the test. When you swallow, the barium can be seen in the x-rays.

What types of barium swallow tests are there?

There are 2 types of these tests:

  • modified barium swallow (MBS), also called a videofluoroscopic swallowing study (VFSS)
  • barium swallow, also called an esophagram

What do I need to tell my doctor or healthcare provider before a swallowing x-ray?

Before your test, tell your doctor or healthcare provider if you:

  • have an allergy to barium
  • are pregnant (or think you might be)
  • are breastfeeding
  • have been sick

If you need x-rays when you’re pregnant, extra precautions will be taken to protect your baby.

About Swallowing X-rays:

What is it?

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • takes pictures of the mouth and throat
  • done while people swallow food and liquids
  • done by a speech-language pathologist (SLP) or an occupational therapist (OT) with a radiologist, or a radiology technologist
  • takes 10 to 15 minutes
  • ​takes pictures of the throat and esophagus
  • done while people swallow liquids
  • done by a radiologist
  • takes 15 to 20 minutes

Why is it done?

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • for swallowing problems with the mouth or throat
  • you might have a problem with the mouth or throat if you have symptoms like coughing or choking when eating or drinking, a wet‑sounding voice, breathing changes when eating or drinking, or lots of chest infections
  • to find out about ways to manage the problem and/or treatment options
  • for swallowing problems with the esophagus
  • you might have a problem with the esophagus if you have symptoms like trouble swallowing, pain while swallowing, chest and stomach pain, bad indigestion, unexplained weight loss, or vomiting
  • to find out about treatment options

How do I get ready?

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • you can eat, drink, or have a tube feed like normal right until you have your test
  • if you're not allowed to eat or drink anything, keep following the instructions your healthcare provider gave you
  • for babies and children, bring:
  • small amounts of food and drink that your child is able to eat or drink
  • small amounts of food or drink that your child has trouble eating and drinking
  • any special cups they use
For Adults
  • must stop eating 4 hours before their test
  • may drink clear liquids (e.g., water, apple juice) until 2 hours before the test
For Children:
  • must stop eating food at least 6 hours before the test
  • can drink clear liquids (e.g., water, apple juice) right until the test starts

Before the test

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • you'll need to remove any clothing or jewellery that is in the areas where the x-rays will be taken
  • you'll have a lead apron put over your pelvic area to protect you from radiation
  • children may have a responsible adult stay in the room with them during the test
  • you'll need to remove any clothing or jewellery that is in the areas where the x-rays will be taken
  • children may have a responsible adult stay in the room with them during the test

During the test

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • you'll sit like you normally do to eat or drink
  • you'll need to drink and eat small amounts of food and liquid, which are mixed with barium
  • you may also need to swallow a barium pill
  • you may be asked to move into different positions during the test
  • you'll be asked to drink 1 to 2 cups of a liquid, which is mixed with barium
  • you'll need to drink the liquid while lying down and standing up
  • you may also need to swallow a barium pill

After the test

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • you can do your regular activities
  • your healthcare provider will tell you what to eat or drink
  • you may feel bloated or have nausea
  • you'll have light-coloured bowel movements for 1 to 2 days

​Risks

​Modified Barium Swallow (MBS​)​ Barium Swallow
  • you'll be exposed to a small amount of radiation (if you have concerns, talk to your healthcare provider)
  • small amounts of liquid and food are given to lower the risk of anything getting into your airway during the test—the test can be stopped at any time if you're having problems
  • if barium gets into your lungs, it is not harmful
  • to prevent constipation from the barium, drink lots of extra fluids for 1 to 2 days after the test
  • if you get constipated, you can take an over-the-counter laxative (ask your doctor or pharmacist about this if needed)
  • if you don't have a bowel movement for 2 to 3 days after your test, talk to your doctor
  • you'll be exposed to a small amount of radiation (if you have concerns, talk to your healthcare provider)
  • there's a risk of barium getting into your airway during the test—the test can be stopped at any time if you're having problems
  • if barium gets into your lungs, it is not harmful
  • to prevent constipation from the barium, drink lots of extra fluids for 1 to 2 days after the test
  • if you get constipated, you can take an over-the-counter laxative (ask your doctor or pharmacist about this if needed)
  • if you don't have a bowel movement for 2 to 3 days after your test, talk to your doctor​​​​​​​


Where to go get help

For more information about how speech-language pathologists and audiologists can help, contact:

  • Your doctor, public health nurse, or other health provider
  • Your local health centre

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