Commonly Performed Radiographic Tests in Gastroenterology
Your doctor has just order some test(s) and you don’t know why or what it will show. The following commonly performed gastroenterology tests and procedures list may help you know what to expect.
- Abdominal X-ray
- Barium Esophagram (Barium Swallow)
- Upper Gastrointestinal Series and Small Bowel Follow Through X-ray
- Barium Enema
- Abdominal Ultrasound, Doppler Ultrasound, and Doppler Mesenteric Ultrasound
- Computed Tomography CT, Computed Tomography (CT) Angiography or Venography & Computed Tomography (CT) Enterography
- Gastric Empting Study
- Cholescintigraphy (HIDA Scan)
- Positron Emission Tomography (PET scan)
An Abdominal X-ray is a common gastroenterology test. This test may be ordered for to find out why you may have unexplained nausea, vomiting or abdominal pain. An Abdominal X-ray test may show a blockage, perforation (tear), or paralysis of your intestinal tract. The technician may have you stand or lie down. The organs absorb different amounts of radiation for the physician to examine showing in varying degrees of black, white, or gray.
Barium Esophagram (Barium Swallow)
A barium esophagram or barium Swallow involves the patient to swallow a liquid (contrast) that will show an image of the inside of the intestine in relation to the wall of the organ and surrounding structures. A barium (thick, white chalky liquid) may be ordered for those who have difficulty or painful swallowing, coughing, choking as if something is stuck in the throat or chest. This barium swallow allows the doctor to see if there is a narrowing in the esophagus called strictures.
Upper Gastrointestinal Series and Small Bowel Follow Through X-ray
An upper GI and small bowel series examines the esophagus, stomach and the first part of the small intestine. Your doctor may have ordered this gastroenterology test because you have symptoms of nausea, vomiting, abdominal pain, with or without weight loss. An upper GI and small bowel series is similar to the barium swallow except it takes a little longer because the barium travels further in the intestinal tract. A small bowel follow through x-ray will require several hours of x-ray film. This test allows the doctor to determine the cause of chronic diarrhea, abdominal pain, or patients with Crohn’s disease.
A barium enema test requires the patient to drink the barium (a thick, white chalky liquid). Patients must complete a bowel-cleansing prep. An endoscope is inserted in the rectum and contrast (dye) is presented throughout the colon. Findings may include colon cancer, polys (which can be biopsied) intestinal inflammation and strictures (narrowing) or diverticulosis. Barium enemas may be used for colon screenings when a colonoscopy cannot be completed.
Abdominal Ultrasound, Doppler Ultrasound, and Doppler Mesenteric Ultrasound
An ultrasound uses sound waves to create images of organs. This ultrasound will show abnormalities in the GI system, such as the liver, gallbladder, bile ducts, pancreas, kidneys, and the abdominal cavity. The sound wave evaluates the blood flow in the arteries and veins which can detect blockage or narrowing.
Computed Tomography CT, Computed Tomography (CT) Angiography or Venography & Computed Tomography (CT) Enterography
A CT scan is a multiple high-resolution-cross-sectional imaging every 5-10 mm. Imagine high quality pictures of the body as if it were being sliced across the middle. A computer then reconstructs the images. This test is usually performed with an oral contrast or intravenous contrast (iodine). Gastroenterologists may order this test to evaluate abdominal pain, to exclude an abscess (infection), and to evaluate the liver, pancreas, small intestine and colon. CT Angiography or Venography evaluates the abdominal arteries or veins. CT Enterography evaluates the small intestine, especially with patients with known or suspected Crohn’ disease.
Virtual Colonoscopy has the same principles as a CT but with the images in 3D. This test requires a bowel preparation, is performed without sedation, has some risks of radiation exposure and involves air introduced into the bowel through the rectum which can cause the patient discomfort. If a polyp or growth is detected, then a colonoscopy needs to be performed. Some small polyps may not be detected and overlooked.
Magnetic Resonance Imaging (MRI), Magnetic Resonance Cholangiopancreatography (MECP, and Magnetic Resonance Angiography (MRA)
A MRI involves use of a high magnetic field to produce high resolution images of the body in various directions. A contrast is introduced (non-iodine) for this non-invasive procedure. This test is used to evaluate intra-abdominal organs, such as the liver or pancreas, for masses or cysts. If the bile and pancreas ducts are examined then this test is named ERCP. The arteries that carry blood to the intestinal tract with a specific MRI, such as MRA or MRI. This test is helpful in patients with known or suspected Crohn’s disease. MRIs are used more because they do not expose patients to radiation.
Gastric Empting Study
A gastric empting study is a nuclear imaging study to evaluate the ability or inability of the stomach to empty. Delayed gastric emptying (gastroparesis), may result from diabetes mellitus. This may result in nausea, vomiting, bloating, sensation of early fullness, or abdominal pain. This test is performed by the patient consuming a meal that contains small amounts of technetium sulfur. Images are taken of the stomach over time. Normally, within a set time, a certain amount of gastric contents exits the stomach and empties into the small intestine. If the amount of contents remaining in the stomach is below the established cut-off values, delayed stomach emptying is diagnosed.
Cholescintigraphy (HIDA Scan)
A Cholescitigraphy is a nuclear scan which evaluates the function of the gall bladder. This test is ordered to diagnose or exclude acute or chronic inflammation of the gallbladder, obstruction of the bile ducts, or a bile leak. If the amount of bile empties from the gall bladder is below the normal range, there may be an issue with gall bladder function.
Positron Emission Tomography (PET scan)
A positron emission tomography is a non-invasive technique used in detecting gastrointestinal cancer. A chemical called 18-flurodeoxyglucose (FGD) is administered and tissues containing cancer take up the chemical. This leads to positive areas on images captured on the scan. This test is ordered to evaluate for distant spread of a tumor (metastasis). Examples would include esophageal, stomach, pancreas, and colon cancer.