If you’re getting ready to have bariatric surgery, you may be a little nervous. You probably have appointments with several medical professionals to determine your eligibility. One of your appointments will be with Radiology for an upper gastrointestinal (UGI) exam. This will be a short exam that will cause no pain or discomfort. We evaluate bariatric patients every day and will tailor the study to accommodate any specific medical conditions or limitations in mobility you might have.
During a routine upper GI exam we look at the lining of your esophagus, stomach and the first part of the small intestine (known as the duodenum) to make sure there is no inflammation or ulcers. We will also ensure that the esophagus moves normally and the stomach empties promptly. These images are observed in real time using a special form of X-ray called fluoroscopy. This requires you to drink a contrast material that includes a mix of water and barium. You will also swallow some crystals that produce air in your stomach, which helps us see inside the upper GI tract better. You will be able to burb up this air at the end of the exam, so it will not cause you to have significant gas later on.
To prepare, you will need to fast after midnight or for at least eight hours before the procedure. You can have a small sip of water with any needed medications the morning of the study.
When you arrive for your UGI exam, you will be asked to put on a gown. If you are more comfortable, you can keep your bottoms on as long as they have no metal on them. We recommend that you wear comfortable pants to allow for easy movement.
You will be asked to drink the barium solution one swallow at a time. Most people tolerate the taste of the barium, but it is a bit chalky. We will take a series of pictures while you are standing and then while lying down to get multiple views. We will watch the movement of the barium through your esophagus, stomach and into the first part of the small intestine on a video screen. You will also be able to watch some of these images too, if you are interested. The entire procedure takes about 30 minutes.
After the upper GI procedure, you can return to a normal diet. We ask that you drink extra water throughout the day to keep the barium moving through your GI tract. We will review all the saved UGI images on a computer and send a final report to your bariatric surgeon. The surgeon also has access to these images for review prior to surgery.
Occasionally, we may recommend additional evaluation. If you have slow emptying of your stomach, which is common with diabetic patients, we will recommend a nuclear medicine exam. If we find polyps, we will recommend an upper endoscopy procedure to ensure the polyps are not cancerous. However, most polyps in the stomach are not cancer.
Your surgeon may order another UGI exam one or two days after your bariatric surgery. This exam will allow us to evaluate the new anatomy of your stomach and small bowel and confirm that everything you swallow stays inside the stomach and small bowel. This exam uses a small amount of thin contrast similar to water and is done in a standing position only.
In most cases, this is the last time we will see you. If you have any problems months or even years after the surgery, your doctor may order an UGI to better understand the source of your problem. But most bariatric patients do great and will never need to see us again! Our goal is to work with the bariatric surgeons to ensure excellent patient care both before and after surgery.