Utility of Barium Swallows in Patients Who Have Had a Recent Upper Gastrointestinal Endoscopy

The purpose of this study was to understand the clinical indications and utility of a barium swallow study in patients who have already been investigated with an upper gastrointestinal (UGI) endoscopy. It would be useful to determine the additional diagnostic information provided by a barium swallow study given endoscopy is considered the gold standard for examining the UGI tract.

This retrospective study examined all barium swallow studies performed at a single tertiary hospital and identified patients who had been investigated with an UGI endoscopy in the preceding 6 months. The radiology request forms, barium swallow reports, UGI endoscopy reports and clinic letters were reviewed to determine the most frequent clinical indications, quantify and characterise new findings on barium swallow and determine the proportion of patients with alteration in management.

Between 1 January 2023 and 30 September 2023, 105 of 318 patients investigated with barium swallow studies had received a recent UGI endoscopy. Over half of the study requests were non-specific, aimed at identifying the cause of dysphagia. A total of 59 studies (56.2%) demonstrated findings that were not apparent on UGI endoscopy. The most common new finding was dysmotility (n = 53, 89.8%). Of the patients with new findings, 24 (40.7%) experienced no change in management, nine (15.2%) were offered lifestyle advice, seven (11.9%) were referred to speech and language therapy and seven (11.9%) were started on medication.

A barium swallow study is a helpful adjunct to UGI endoscopy, especially in the diagnosis of dysmotility.