Barium Swallow Vs. Endoscopy: What’s the Difference?

Two procedures used to examine the upper gastrointestinal (GI) tract are a barium swallow and an endoscopy. While they are related in their goal of helping your doctor assess areas and structures in your digestive tract that cannot be viewed externally, they are very different processes. A barium swallow enables your physician to diagnose relatively simple medical conditions solely through the use of X-rays. More difficult-to-diagnose procedures may require endoscopy, which is an invasive procedure requiring the insertion of a small camera into the upper GI.

What Is an Endoscopy?

An endoscopy allows surgeons to see problems inside your body without having to make surgical incisions. In the case of an upper GI endoscopy, a specialized flexible tube with a light and camera attached to it is inserted through your mouth and down into your GI tract. The scope allows your doctor to see interior structures in much greater detail than an X-ray. Attached to the scope are forceps and scissors, which allow the removal of tissue for further examination and biopsy if appropriate.

EGD Vs. Endoscopy

What is the difference between EGD and endoscopy? An endoscopy is another term for an EGD procedure. You will sometimes see endoscopies referred to as EGDs. EGD is another name for the same procedure. EGD stands for esophagogastroduodenoscopy.

What Is an Endoscopy Used to Diagnose?

Your doctor may order an endoscopy if you have

Symptoms such as:

• Bleeding in the digestive tract
• Abdominal pain
• Nausea and vomiting
• Swallowing problems
• Weight loss

Conditions such as:

• Stomach ulcer
• Gastroesophageal reflux disease or GERD (acid reflux) and heartburn
• Tumors (cancerous and noncancerous)
• Infections, inflammation, or allergic conditions of the esophagus (esophagitis, gastritis, and duodenitis)
• Hiatal hernia
• Swallowing disorders
• Gastrointestinal disorders (celiac disease or Crohn’s disease)

What Is a Barium Swallow?

A barium swallow is an X-ray procedure in which you swallow a chalky, white substance called barium that is typically a thick drink with the consistency of a milkshake. This exam is used to provide images of your GI tract. This includes your pharynx (the back of your mouth and throat), esophagus (the tube that starts behind your tongue and runs down to your stomach), stomach, and the first part of your small intestine, which is called the duodenum.

The barium coats the surface of your upper GI tract and appears white on X-rays. The procedure produces detailed images of the linings of the tract and can provide insight into the motion of your swallowing.

Barium Swallow Vs. Esophagram

Barium swallows are also known as esophagram procedures. Esophagrams are the X-ray images produced by a barium swallow test.  

What is a Barium Swallow Used to Diagnose?

A barium swallow can help diagnose a number of conditions, including:

• Cancerous and noncancerous tumors
• Inflammation
• Blockages
• Ulcers
• Gastroesophageal reflux disease (GERD)
• Hiatal hernia
• Muscle disorders that cause spasms or problems with swallowing.

Should I Get a Barium Swallow or an Endoscopy for Upper GI Problems?

The main advantage of a barium swallow is that it is less invasive because it’s a special type of X-ray. While many patients report that swallowing the barium is unpleasant, no instruments are inserted into the body. An endoscopy is a more invasive procedure, but it enables a doctor to immediately see the structures or areas of interest and to take actions such as removing tissue for biopsy.

Your physician’s decision to perform a barium swallow or an endoscopy will depend on several factors, including the nature of your symptoms, the potential diagnosis, and your comfort level with the procedures. In some cases, if a barium swallow proves insufficient for diagnosis, an endoscopy might still be required. Be sure to speak with your doctor about your diagnostic and treatment options.

What Are the Main Differences Between a Barium Swallow Vs. Endoscopy

Endoscopies and barium swallows are distinguished by the way they’re conducted and the degree of information they provide. There are other significant differences between the two as well.

Sedation

Patients undergoing a barium swallow rarely require sedation. As is typical of X-rays, you remain awake during the procedure. On the other hand, an endoscopy usually requires some degree of sedation. Few of us have the patience to lie still while our physician is manipulating a scope inside our body. Moderate to heavy sedation is typical, to reduce irritation and anxiety during the procedure. Heavy sedation leads to the temporary loss of consciousness (sleep state). You will have no memory of the procedure on waking.

Degree of Invasiveness

The main advantage of a barium swallow is that it is less invasive because it is a special type of X-ray. While many patients report that swallowing the barium is unpleasant, no instruments are inserted into the body. An endoscopy is a more invasive procedure, but it enables a doctor to immediately see the structures or areas of interest and to take actions such as removing tissue for biopsy.

Side Effects

Both barium swallow and endoscopy are typically outpatient procedures, meaning you can go home the same day. Each has side effects that are generally mild. These include constipation with a barium swallow and a sore throat with an endoscopy. In both procedures, the side effects tend to resolve on their own with proper aftercare such as hydrating and eating high-fiber foods after a barium swallow and eating soft foods after an endoscopy.

Learn More About Barium Swallow and Endoscopy Procedures from Baptist Health

Baptist Health provides safe and efficient inpatient and outpatient diagnostic imaging, including endoscopies and barium swallow X-rays. As one of the area’s most advanced diagnostic imaging centers, our services are fully integrated with our excellent medical care. In this way, we work together to detect the earliest signs of disease or injury and provide expert treatment.

If you need diagnostic imaging, you can count on the compassionate and skilled team at Baptist Health to be with you every step of the way. From helping you prepare for your tests to listening carefully to your questions and clearly explaining everything you need to know, you’ll appreciate our careful attention and support.

To schedule an appointment, contact your Baptist Health primary care provider.