A Barium Follow-Through (also called Small Bowel Follow-Through) is a special X-ray examination used to assess the small intestine– the long, coiled part of the digestive tract between the stomach and large intestine.
It helps doctors see how well food moves through your small intestine and detect any structural or functional problems.
The test uses a contrast material called barium sulfate, which coats the lining of your intestines, making them clearly visible on X-ray images.
Why is a Barium Follow-Through done?
Your doctor may request a Barium Follow-Through to investigate symptoms such as:
- Persistent abdominal pain or bloating
- Chronic diarrhea or constipation
- Unexplained weight loss
- Blood in stool or signs of intestinal bleeding
- Suspected Crohn’s disease, inflammation, or strictures
- Malabsorption or unexplained digestive problems
This test helps assess the structure, movement, and health of the small intestine, identifying abnormalities that may not appear on other scans.
How should I prepare for a Barium Follow-Through?
- You’ll be asked not to eat or drink anything for about 6–8 hours before the test, so your stomach and intestines are empty.
- Avoid smoking or chewing gum before the procedure, as these can stimulate stomach movement.
- Inform your doctor or radiographer if you are pregnant or might be pregnant.
- Remove jewelry or any metallic items from your abdomen area before the test.
- If you are on medication, your doctor will advise whether to continue or temporarily stop it before the examination.
What happens during a Barium Follow-Through procedure?
- You’ll be asked to drink a white, chalky liquid (barium sulfate), which coats the inside of your stomach and small intestines.
- A series of X-rays will be taken at intervals as the barium travels through your small intestine.
- You may need to lie on your back, stomach, or side during the process to obtain different views.
- The radiographer or radiologist may gently press on your abdomen or tilt the examination table slightly to help the barium move along.
- The test duration varies, it can take 1 to 3 hours, depending on how quickly the barium passes through your intestines.
Is the procedure painful?
No, the test is painless and non-invasive. You may feel full, bloated, or have an urge to pass gas as the barium moves through your intestines, but this is temporary and harmless.
Are there any risks or side effects?
The test is safe, though a few mild side effects may occur:
- Temporary constipation
- White or pale stools for a few days
- Mild bloating or abdominal discomfort
To prevent constipation, drink plenty of fluids after the test unless otherwise instructed.
Can I eat or drink after the test?
Yes. You can eat and drink normally once the test is complete.
It is advised to drink plenty of water throughout the day to help flush the barium out of your system.
When will I get my results?
The X-rays will be reviewed by a Radiologist, who will prepare a detailed report for your doctor. Results are usually ready within 24–48 hours, depending on the facility.
Can children have a Barium Follow-Through?
Yes. The procedure can safely be performed in children when clinically necessary. The radiology team will use a smaller dose of barium and ensure the child’s comfort throughout the test.
Can I have a Barium Follow-Through if I am pregnant?
Pregnancy Precaution
The study is generally deferred or replaced during pregnancy when practical because it uses ionising radiation. If the question is urgent, the referrer and radiology team should make an individual benefit-risk decision.
If you are or might be pregnant, let your doctor or radiographer know before the test.
What is the difference between a Barium Meal and a Barium Follow-Through?
A Barium Meal examines the stomach and upper small intestine (duodenum), while a Barium Follow-Through focuses on the entire small intestine.
In many cases, both tests can be done together, the Barium Meal first, followed by the Follow-Through to give a complete view of the upper digestive system.
What are the important limitations and safety checks?
Fluoroscopy shows movement or anatomy during a specific examination, but it does not guarantee a diagnosis or exclude every abnormality. Image quality and interpretation can be limited by positioning, movement, body size, retained contrast, overlying structures, incomplete filling, or the patient's ability to complete the study. Further endoscopy, ultrasound, CT, MRI, laboratory testing, or tissue sampling may still be needed.
Fluoroscopy uses ionising radiation. Dose varies with the body area, examination complexity, equipment, patient size, and imaging time; the team should use the lowest exposure that still answers the clinical question. Tell the team before the examination if you are or may be pregnant. Pregnancy does not create a universal ban: the referrer and imaging team should decide whether to defer, modify, or proceed when the expected benefit outweighs the risk.
Contrast and preparation are procedure-specific. Barium, water-soluble iodinated contrast, intravenous contrast, and contrast placed into a joint, bladder, uterus, duct, or fistula have different risks. Tell the team about prior reactions, swallowing or aspiration problems, suspected perforation, kidney or thyroid disease, diabetes, medicines, and recent contrast studies. Do not fast, stop medicines, interrupt breastfeeding, or take bowel preparation or antibiotics based only on a general webpage; follow the center's written instructions.
Questions to ask the fluoroscopy team
- What exact question should this examination answer, and is a radiation-free or non-invasive alternative suitable?
- Which contrast route and agent will be used, and what preparation, pregnancy, breastfeeding, allergy, kidney, diabetes, or medicine instructions apply to me?
- Will a catheter, internal examination, sedation, or pain relief be needed, and may I stop the procedure if I am uncomfortable?
- What symptoms require urgent help afterward, when will the signed report be ready, and who will explain the result?
Sources and further reading
- RadiologyInfo.org: Fluoroscopy
- American College of Radiology: Manual on Contrast Media
- RadiologyInfo.org: Radiation safety for children
Conclusion
A Barium Follow-Through is a safe and effective imaging test that provides valuable information about the small intestine’s structure and movement.
By following preparation instructions and staying hydrated after the procedure, you’ll help ensure accurate results and a smooth recovery.
Want to learn more?
There are other barium studies that focus on different parts of the digestive system. Check out Barium Swallow, Barium Meal, and Barium Enema to see what they entail.