Chloe's GI Appointment

Chloe had an upper GI done on 3/21/08. I haven’t received the report yet but I was told that it went well. Chloe has a small bowel. Her small and large intestines are reversed as well has her colon. Her intestines & colon are slightly more to one side. They will repeat the upper GI in a few years again to make sure that there are no problems. As a parent with a child with Heterotaxy I push for certain tests to take place (it is better to be safe.)

An upper GI series is a radiographic examination that produces x-ray images of your upper gastrointestinal tract, including the esophagus, stomach and small bowel or intestine. (The esophagus is the tube that runs from your mouth to your stomach.) This examination is performed for people with Heterotaxy because of their high incidence of intestinal malrotation and the risk of volvulus. Mid-gut volvulus may lead to a potentially life-threatening complication. To simplify it mid-gut volvulus is prone to twist counter clockwise around the superior mesenteric artery and vein.

For the upper GI examination to be successful, your stomach and upper GI tract must be completely empty. In Chloe’s case they wanted her stomach emptied for 6 hours prior to the examination. In some cases, you also may be required to take a laxative to help clear your digestive tract before the exam. Your doctor or the radiology department will give you specific instructions, which you should follow closely.

When you arrive for your examination, a radiographer will explain the process to you and answer any questions you might have. The radiographer will determine the amount of radiation necessary to produce a diagnostically useful image. Parents are often worried about this and should ask lots of questions to ease their concern.
Before the upper GI examination, the radiographer will give you a hospital gown to wear. This gown has no metal snaps on it, because metal can interfere with the interpretation of the image.

As always if you are a woman and maybe pregnant you should let the radiographer know immediately. It is important that you tell the radiographer the date of your last menstrual period just in case there is a chance.

The examination takes a long time. In Chloe’s case 5 hours because they were looking for any malrotation of the intestines. This includes prep time. Inside the x-ray room, the radiographer will take an x-ray of your abdomen to make certain that your stomach is empty. Next, you will be asked to stand at the end of an erect x-ray table or to lie down on a tilting table attached to a fluoroscope, which is a x-ray unit combined with a television screen. A radiologist will come into the room and give you liquid barium to drink. Barium is a special white or pink compound that permits radiographic image of the gastrointestinal tract. The Barium can be flavored and make sure to ask them what flavors they have. Chloe had strawberry flavored Barium. It coats the walls of your upper digestive tract, casting shadows that can be recorded on x-ray film.

Some people may be also asked to swallow "fizzy" granules to help put air (gas) into your stomach, which will distend it. You may feel a need to belch. You should try not too “belch” if you can. Between the air and the barium will permit the radiologist to see your stomach in much better detail.

As the barium flows down your digestive tract, the radiologist will ask you to turn in various positions while he looks at your and stomach on the fluoroscope. X-rays will be taken throughout the procedure. Make sure to let them know, if you feel uncomfortable or are not able to turn over, you should tell the radiographer or radiologist. Keep in mind that they want to make you as comfortable as possible and at the same time perform a successful exam. You should also tell them if your child needs to take a break. Please keep in mind that this is a long exam and your child may be become irritable. Remember to bring rewards for your children for doing a good job. Every time there is a break give them something to enjoy. NO food or drinks but small little odds and ends toys, coloring books or there favorite character books to read.

After the fluoroscopic portion of the examination is finished, the radiographer will take regular x-rays of your stomach and abdomen. You may be asked to drink extra amounts of barium.

When the exam is complete, the radiographer will process your x-ray films and decide whether they are technically satisfactory. The films then will be given to a radiologist to interpret. Radiologists specialize in the understanding of medical images. Also be prepared that you might need to take more x-rays and drink more of the barium solution.

At this point, the images will have to be reviewed by the radiologist. You’ll also have to wait for your doctor to get back to you with a report on the findings. Then your doctor will advise you of the results and discuss what further procedures, if any, are needed.

Make sure to have your child drink lots of water for the next few days following the exam. The barium may make your stools white for a few days. This is normal. If you experience constipation following the examination, tell your doctor. They may advise you to take a laxative.

Please make sure to contact your doctor with specific questions about a medical imaging procedure and for more information.

For further information please see:
http://radiographics.rsnajnls.org/cgi/content/full/26/5/1485