Diagnosing Gastrointestinal Disorders

Doctors have several types of tests at their disposal to diagnose gastrointestinal (GI) disorders. These include lab tests, MRI, CT, ultrasound, X-ray, colonoscopy, and more. Often, doctors order a type of moving X-ray called fluoroscopy to assess patients’ GI health. Because it creates a moving image, fluoroscopy allows radiologists to watch the digestive tract in action.

Symptoms That May Warrant a GI Exam

The symptoms that can prompt a GI exam are many and varied. Examples include

• Difficulty swallowing
• Feeling of a lump in the throat or chest
• Unexplained vomiting or vomiting blood
• Unexplained weight loss
• Persistent or severe abdominal pain
• Unusual bloating
• Changes in bowel movements
• Blood in stools or black, tarry stools
• Chronic diarrhea or constipation
• Persistent fatigue or feeling generally unwell in addition to Gi symptoms

Fluoroscopy for GI Assessment

Fluoroscopy can be used to examine either the upper or lower GI tract. An upper GI exam focuses on the esophagus, stomach, and small intestine, while a lower GI exam assesses the colon and rectum and may also include the appendix and a portion of the small intestine. A doctor might order an upper GI exam to investigate symptoms like trouble swallowing, indigestion, or vomiting or a lower GI exam to look into issues like diarrhea, weight loss, or bloody stools.

What happens in a fluoroscopy exam?

Before beginning a GI fluoroscopy, the patient is given barium contrast, either as a drink (for an upper GI exam), an enema (for a lower GI exam), or both. For a lower GI exam, air may also be pumped into the rectum to allow greater visibility.

Barium is a white, chalky substance that coats the insides of the GI tract and shows up white on X-rays. This allows the radiologist to observe abnormalities that may not otherwise be visible on X-ray images. For some exams, patients are asked to fast or observe specific dietary guidelines prior to their appointment.

As the patient lies on the exam table, the radiologist observes the progress of the barium through the body on a TV-like monitor. Depending on the type of exam being performed and how long it takes the barium to move through the body, a GI fluoroscopy can take anywhere from 30 minutes to several hours.

What can GI fluoroscopy detect?

Fluoroscopy can help radiologists identify a number of different gastrointestinal conditions. For example, a lower GI fluoroscopic exam can help detect ulcerative colitis (a form of inflammatory bowel disease), polyps, cancerous tumors, diverticulitis, and blockages of the large bowel. An upper GI exam can be used to identify tumors, blockages, inflammation, scarring, ulcers, strictures, hiatal hernias, and muscular wall abnormalities.

What happens next?

After the exam, the barium contrast can cause constipation and turn stools white and chalky. Doctors advise drinking plenty of water and consuming foods that are high in fiber to help the body eliminate the barium. The radiologist will review the fluoroscopy images and then send a report to the referring provider. After receiving the radiologist’s report, the referring physician discusses the results with their patient.

Fluoroscopy at Iowa Radiology

Iowa Radiology is dedicated to providing exceptional patient care. We understand that when patients come to us for diagnostic testing, it’s not their best day. We take the time to answer all our patients’ questions, address any concerns, and help them be as comfortable as possible during their time in our clinics. Our radiologists contact referring providers with fluoroscopy results within one business day.

Resources

Barium X-Rays (Upper and Lower GI). HopkinsMedicine.org. Accessed November 15, 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/barium-xrays-upper-and-lower-gi.

Digestive Diagnostic Procedures. HopkinsMedicine.org. Accessed November 15, 2021. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/digestive-diagnostic-procedures.

GI X-Ray Examinations. Cleveland Clinic.org. Reviewed November 10, 2014. Accessed November 15, 2021. https://my.clevelandclinic.org/health/diagnostics/7144-gi-x-ray-examinations

X-Ray (Radiography)—Lower GI Tract. RadiologyInfo.org. Reviewed May 5, 2019. Accessed November 15, 2021. https://www.radiologyinfo.org/en/info/uppergi. 

X-Ray (Radiography)—Lower GI Tract. RadiologyInfo.org. Reviewed July 20, 2021. Accessed November 15, 2021. https://www.radiologyinfo.org/en/info/lowergi.