Penn State Hershey Medical Center home Penn State Hershey Medical Center home Penn State Hershey: Patient Care home Penn State Hershey: Education home Penn State Hershey: Research home Penn State Hershey: Community home
Penn State Hershey Health Information Library
  Library Home
  Find A Physician
  Find A Practice
  Request An Appointment
  Search Clinical Studies
  Classes and Support Groups
  Ask A Health Librarian
  Subscribe to eNewsletters

Penn State Hershey Health Information Centers
  Bone and Joint

        Follow Us
Decision Assist

GI tests


The purpose of this tool is to help you decide whether or not to have an upper or lower GI test. When making a decision like this, you must balance:

  • The reasons for having a test
  • The potential health risks, drawbacks, or limitations of the procedure
  • Whether there are alternative procedures that may be more appropriate
  • Cost

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. There is usually no exact “right” or “wrong” answer.

Your physician may make certain recommendations to you. However, the final decision about whether to have these tests rests with you.

What is the test?

An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. X-rays occur after the patient has swallowed a barium suspension (contrast medium) – usually in the form of a milk shake. A lower GI test examines the large intestines. In this test, barium is placed into the rectum and travels upward into the rest of the colon.

Lower digestive anatomy

X-rays are a form of electromagnetic radiation, like light, but strong enough to penetrate the body to form an image on film. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray. Barium is very dense and will appear white on the x-ray film.

Click the icon to see an illustration detailing x-rays.

The purpose of an upper GI series is to detect anatomic or functional problems in the esophagus, stomach, and small intestine. A lower GI series (also called a barium enema) can detect colon cancer. A barium enema may also be used to diagnose and evaluate the extent of inflammatory bowel diseases.

Key points

  • Barium x-rays may be used to find the source of bleeding (vomiting blood or passing blood in your bowel movements), if you have problems swallowing, or if you have stomach pain or heartburn.
  • Barium x-rays can identify abnormalities in the GI tract, including tumors, ulcers, narrowed portions of the intestines (strictures), structural problems, and abnormal connections between parts of the intestines (fistulas).
  • Often, barium examinations are used to confirm or evaluate findings from other imaging techniques, such as computed tomography, magnetic resonance, or ultrasound.
  • The risks of these tests are small and include low level exposure to radiation and discomfort during the test.
  • The tests may be done in an office or a hospital radiology department.
  • You may be given a restricted diet for 2 or 3 days before the test.
  • Be sure to check with your health care provider regarding any dietary or medication restrictions before the test.

How much time this decision tool will take

  • 5 - 10 minutes

What this tool will provide

  • A personalized list of factors for you to weigh
  • Questions to ask your doctor
  • Alternatives to this test
  • Recommended reading

Review Date: 9/19/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

  • Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 136.
  • Rosman AS, Korsten MA. Meta-analysis comparing CT colonography, air contrast barium enema, and colonoscopy. Am J Med. 2007 Mar;120(3):203-210.e4. Review.
  • Smith RA, Cokkinides V, Brawley OW. Society Guidelines and Cancer Screening Issues. Cancer Screening in the United States, 2008: A Review of Current American Cancer. CA Cancer J Clin. 2008;58;161-179; originally published online Apr 28, 2008.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.