Barium Swallow In Cases Of Barrette’s Esophagus

Q. I want to ask that if someone has Barrett’s esophagus and if he undergoes Barium swallow x ray , then will undergoing barium swallow x ray increase chances of esophageal cancer? I am asking specifically for Barrett’s esophagus, that if some one has Barrett’s esophagus and if he undergoes Barium swallow x ray , then will undergoing barium swallow x ray increase chances of esophageal cancer?

In other words if one has Barrett’s esophagus and if he undergoes barium swallow x ray then will this x ray promotes Barrett’s esophagus to turn in esophageal cancer?

Let’s first understand your condition, what is Barrett’s Esophagus.

Barrett’s esophagus

Esophagus or food pipe is a connecting pipe from the mouth leading to the stomach. At the juncture between the end of this tube and beginning of the stomach, there a muscular sphincter. This ring like muscular gate functions in such a way that it allows food to enter from the esophagus to the stomach and not the other way round.

However, sometimes, this sphincter control is compromised.  It becomes loose. This may permit stomach acid to enter into the esophagus. Loose sphincter make the lower most end of esophagus prone to getting in touch with the stomach acid.

Repeated exposures of esophageal lining with stomach acid corrodes it and leads to a condition called Barrett’s esophagus. The innermost lining of the esophagus starts inflaming and corroding.

                Normal Esophageal Lumen                             Barrette’s Esophageal Lumen

Patient may complain of chest pains and frequent heart burns. The innermost mucousal lining slowly starts showing metaplastic and dysplastic changes.

Why is barium swallow x ray done in cases of Barrett’s esophagus?

Barium swallow x ray is one of the diagnostic tools in treating and managing Barrett’s esophagus. So, it is done almost routinely to confirm the condition.

Barium Swallow X Ray

• Patient is asked to have nothing a for few hours before the test. When he arrives for the test, he is made to drink a barium solution, which may or may not be flavored. It’s chalky is taste.
• This barium solution goes into his GI tract, all the while, sticking closely to the inner walls of the alimentary canal. The patient is made to stand for some time to aid downward movement of barium. As barium enters inner loops of the intestine, he may lie down.
• X rays are then done to visualize the alimentary canal, which is now lined precisely by barium, just like a chalk is used to outline some tract. Even small growths, ulcers or any other finer growths get visualized this way.
• Barium is not digested by our gut. It is excreted out gradually. One may get whitish poo for a 1 to 2 days after this test.

                                           Barium swallow showing the alimentary canal

Radiation Risk

Radiation risk involved in this test is almost the same as any other X ray done. It’s not more due to barium use.

Barium Swallow X Ray In Cases of Barrett’s Esophagus

This test is done routinely in patients of Barrett’s esophagus. Radiation risk involved is minimal, comparable to ordinary X Rays.

Barrett’s Esophagus And Malignancy

In cases of Barrett’s esophagus, the innermost lining of the esophagus is continuously irritated. This gives rise to severe inflammatory changes there.

If left unchecked, this long standing irritation may cause cells involved to change gradually to become cancerous. It’s not uncommon to see malignancies in long standing cases of Barrett’s esophagus. Incidence is about 5 in hundred.