Esophagram

An esophagram (e-SOFF-ah-gram) is an X-ray test that takes pictures of the esophagus (ee-SOFF-ah-gus). The esophagus is the tube in the neck that connects the mouth to the stomach through which food passes as it is eaten.

• X-ray pictures are taken after the child drinks a special liquid called barium (BARE-ee-um) that coats and outlines the walls of the esophagus.
• An esophagram shows doctors how well the esophagus is working.
• An esophagram gives doctors detailed information about your child’s esophagus that they cannot learn from a physical examination.

On the day of the test, your child should not eat or drink anything before the test is done following these guidelines:

• Neonates – 2 hours before
• All other ages – 4 hours before
• Medications can be taken with minimal amount of water.
• If you have any questions regarding these requirements, please contact the Department of Pediatric Radiology.
• You may bring along a “comfort” item—such as a favorite stuffed animal or “blankie”—for your child to hold during the test.

The esophagram is done at the Department of Pediatric Radiology of Children’s Hospital. In the examination room will be a pediatric radiology doctor, who will be taking the X-ray pictures of your child’s esophagus, and an X-ray technologist, who will be helping the doctor. You will see an X-ray machine, a long table and a television screen. You might explain to your child that the X-ray machine is a large camera for taking pictures that will be shown on the screen. If your child has any questions, the doctor or X-ray technologist will be happy to answer them before the test.

Your child will be asked to remove his or her clothing and put on a hospital gown. When your child is ready, he or she will go to the fluoroscopy (floor-OS-co-pee) room and the test will begin.

• Your child will be awake during this test.
• Your child will be asked to lie down on the table.
• In the fluoroscopy room, your child will be given a milky liquid called barium in a cup to drink with a straw. This liquid allows the doctors to see the esophagus better on the X-ray pictures. Barium looks like a milkshake, but does not have a pleasant taste. The doctor or X-ray technologist can add flavoring to the barium to make it taste better if your child wants it flavored.
• If your child is unable to drink the barium, a thin flexible tube may be placed through his or her nose to get the barium into the esophagus.
• As your child drinks the barium, the doctor will move the X-ray camera over your child. The camera will come close to, but not touch, your child.
• The doctor will begin to take the X-ray pictures as soon as the barium is swallowed and passes through the esophagus.
• When the milky liquid has passed through the esophagus, the esophagram test is over.

As a parent, you may have concerns about radiation exposure. Children’s Hospital takes every precaution to make sure your child is safe.

• Our goal is to do the test correctly and thoroughly, while exposing your child to the smallest amount of radiation necessary to take the X-ray.
• Advances in equipment and film have lowered the amount of radiation your child will receive.
• All of the equipment is inspected regularly.
• Parts of the body that are not being X-rayed will be protected with a lead cover or apron when possible.

We welcome your help and support during this test. Parents or guardians are invited to join your child in the examination room. Other children can wait in the waiting room or the Lemieux Sibling Center if siblings are ages 3 to 12 who are toilet trained.

• This test involves the use of radiation. Women who are pregnant or believe they may be pregnant should limit exposure to X-rays. In this case, please bring another adult who can stay with your child during the test.

The X-ray technologist will show you where to stand in the examination room during the test. Please follow the instructions of the medical professionals performing the test.

• The most important role of a parent or guardian during the test is to help your child stay calm and relaxed. It is important that your child stays still when the X-ray pictures are being taken.
• The best way to help your child stay calm is for you to stay calm.
• We encourage you to talk to your child and hold his or her hand.
• You may bring along a “comfort” item-such as a favorite stuffed animal or “blankie”—for your child to hold during the test.
• Please do not distract the medical team or interrupt the test in any way.
• We welcome your questions, but please ask them either before or after the test.

The esophagram takes about 15 to 30 minutes. When the doctor and X-ray technologist have taken all the X-rays they need, they will check to make sure the pictures are clear, which takes only a few minutes. When they are satisfied with the pictures, the esophagram is finished.

• Before leaving, you will be told about any follow-up care.
• Your child’s bowel movements will look white for a day or two because of the barium. White bowel movements are normal.
• After the test, your child can return to normal activities and resume a normal diet.
• Your child should drink plenty of liquids to allow his or her bowel movements to return to normal.
• Your child may have some constipation. Drinking lots of liquids will help. Your child may also take a mild laxative.
• If your child’s constipation continues, please contact your family doctor or PCP for advice and treatment.
• A report of your child’s esophagram will be sent to the doctor who prescribed it, usually within 48 hours. If the results are urgent, the referring doctor will be contacted immediately.
• Please contact the doctor who prescribed the test for the results.
• If you have any other questions or concerns about the test, please call the Department of Pediatric Radiology and a nurse or X-ray technologist will discuss them with you.

If your child has any special needs or health issues you feel the doctor needs to know about, please call the Department of Pediatric Radiology at Children’s before the test. It is important to notify us in advance about any special needs.

Preparing your child beforehand, as well as comforting your child during the test, will help your child have a more positive experience. Sometimes it is difficult to know how to explain tests to children. If you have any questions about ways to prepare or support your child, or feel your child will have difficulty during the test, please call the Department of Pediatric Radiology at Children’s and ask to speak with the Child Life Specialist.