Barium sulfate suspension

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Barium sulfate suspension
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3D model of barium sulfate
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administration 		By mouth, rectal
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Chemical and physical data
Formula BaO4S
Molar mass 233.38 g·mol−1

Barium sulfate suspension, often simply called barium, is a contrast agent used during X-rays. [1] Specifically it is used to improve visualization of the gastrointestinal tract (esophagus, stomach, intestines) on plain X-ray or computed tomography. [2] It is taken by mouth or used rectally. [3]

Contents

Side effects include constipation, diarrhea, appendicitis, and if inhaled inflammation of the lungs. [2] It is not recommended in people with intestinal perforation or bowel obstruction. [2] Allergic reactions are rare. [1] The use of barium during pregnancy is safe for the baby; however, X-rays may result in harm. [4] Barium sulfate suspension is typically made by mixing barium sulfate powder with water. [1] It is a non-iodinated contrast media. [5]

Barium sulfate has been known since the Middle Ages. [6] In the United States it had come into common medical use by 1910. [7] It is on the World Health Organization's List of Essential Medicines. [8] Some versions contain flavors to try to make it taste better. [1]

Medical uses

Barium sulfate suspensions are provided by a radiologist or radiographer in advance of, or during a CT scan or fluoroscopic study to allow for better visualization of the gastrointestinal tract, such as in upper or lower gastrointestinal series. In upper gastrointestinal series, the patient is instructed to take nothing by mouth, which means to abstain from eating and drinking (fasting), with the exception of drinking the barium sulfate suspension. The amount of time for this fast may vary, depending on the instructions given by the imaging facility and the area of the body to be scanned, but generally lasts for several hours prior to the scan. The patient generally skips one meal, along with abstaining from all liquids, clear or otherwise, during this time.

Consumption of the barium sulfate suspension begins 90 minutes to two hours prior to the CT/Fluoroscopic scan, as instructed in the patient education provided. For a Barium Swallow or Dysphagiagram the barium is consumed after the study begins to discern if the patient has difficulties swallowing or masticating. Consumption is paced, beginning two hours before the scan is to occur, with levels marked on the provided container indicating how much is to be consumed between each of the two hours prior to the test. A small portion of the suspension is reserved for the minutes just before the test, to ensure that as much of the gastrointestinal tract as possible is coated.

After the scan is complete, the patient is encouraged to eat and drink normally, with special attention to plenty of fluids. The barium sulfate is excreted through defecation, so extra fluid intake helps prevent constipation, which is a possible side effect (see Johns Hopkins Medicine Health Library for an example of a possible patient education instruction sheet). [9]

Side effects

Side effects include nausea, diarrhea, a feeling of weakness, pale skin, ringing in the ears, constipation, and vomiting. [10]

Taste and texture

Oral barium sulfate suspensions are sometimes described as having the consistency of a very thick glass of milk, or a very thin milkshake. [11] Some patients may experience the texture as a chalky liquid, similar to calcium carbonate containing liquid antacids and with a slight medicinal taste. [12]

Some preparations of barium sulfate have added flavors to make them easier to tolerate. In general, the flavor is considered unpleasant, and is dependent on the exact makeup of the drink. [13]

Related Research Articles

<span class="mw-page-title-main">Defecation</span> Expulsion of feces from the digestive tract

Defecation follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus or cloaca. The act has a variety of names ranging from the common, like pooping or crapping, to the technical, e.g. bowel movement, to the obscene (shitting), to the euphemistic, to the juvenile. The topic, usually avoided in polite company, can become the basis for some potty humor.

<span class="mw-page-title-main">Esophagitis</span> Inflammation of the esophagus

Esophagitis, also spelled oesophagitis, is a disease characterized by inflammation of the esophagus. The esophagus is a tube composed of a mucosal lining, and longitudinal and circular smooth muscle fibers. It connects the pharynx to the stomach; swallowed food and liquids normally pass through it.

<span class="mw-page-title-main">X-ray machine</span> Machine that generates X-rays

An X-ray machine is a device that uses X-rays for a variety of applications including medicine, X-ray fluorescence, electronic assembly inspection, and measurement of material thickness in manufacturing operations. In medical applications, X-ray machines are used by radiographers to acquire x-ray images of the internal structures of living organisms, and also in sterilization.

<span class="mw-page-title-main">Pulmonary aspiration</span> Entry of materials into the larynx (voice box) and lower respiratory tract

Pulmonary aspiration is the entry of solid or liquid material such as pharyngeal secretions, food, drink, or stomach contents from the oropharynx or gastrointestinal tract, into the trachea and lungs. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe".

<span class="mw-page-title-main">Lower gastrointestinal series</span> Radiographs used to examine abnormalities of the colon

A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs are taken while barium sulfate, a radiocontrast agent, fills the colon via an enema through the rectum.

<span class="mw-page-title-main">Fluoroscopy</span> Production of an image when X-rays strike a fluorescent screen

Fluoroscopy, informally referred to as "fluoro", is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope allows a surgeon to see the internal structure and function of a patient, so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery.

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs arise in the smooth muscle pacemaker interstitial cell of Cajal, or similar cells. They are defined as tumors whose behavior is driven by mutations in the KIT gene (85%), PDGFRA gene (10%), or BRAF kinase (rare). 95% of GISTs stain positively for KIT (CD117). Most (66%) occur in the stomach and gastric GISTs have a lower malignant potential than tumors found elsewhere in the GI tract.

<span class="mw-page-title-main">Upper gastrointestinal series</span> Radiographs used to examine abnormalities of the digestive system excluding the colon

An upper gastrointestinal series, also called a barium swallow, barium study, or barium meal, is a series of radiographs used to examine the gastrointestinal tract for abnormalities. A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest. The barium enhances the visibility of the relevant parts of the gastrointestinal tract by coating the inside wall of the tract and appearing white on the film. This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner. With fluoroscopy, it is also possible to visualize the functional movement of examined organs such as swallowing, peristalsis, or sphincter closure. Depending on the organs to be examined, barium radiographs can be classified into "barium swallow", "barium meal", "barium follow-through", and "enteroclysis". To further enhance the quality of images, air or gas is sometimes introduced into the gastrointestinal tract in addition to barium, and this procedure is called double-contrast imaging. In this case the gas is referred to as the negative contrast medium. Traditionally the images produced with barium contrast are made with plain-film radiography, but computed tomography is also used in combination with barium contrast, in which case the procedure is called "CT enterography".

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References

  1. 1 2 3 4 Bontrager KL, Lampignano J (2013). Textbook of Radiographic Positioning & Related Anatomy. Elsevier Health Sciences. p. 461. ISBN   978-0-323-13613-6.
  2. 1 2 3 Stuart MC, Kouimtzi M, Hill S, eds. (2009). WHO model formulary 2008. World Health Organization. pp. 315, 317. hdl: 10665/44053 . ISBN   978-92-4-154765-9.
  3. ↑ "E-Z-Paque - Summary of Product Characteristics (SPC)". Electronic Medicines Compendium (EMC). Datapharm Ltd. Archived from the original on 1 January 2017. Retrieved 31 December 2016.
  4. ↑ "E-Z-CAT - Summary of Product Characteristics (SPC)". Electronic Medicines Compendium (EMC). Datapharm Ltd. Archived from the original on 1 January 2017. Retrieved 31 December 2016.
  5. ↑ Hamilton RJ (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning, LLC. p. 171. ISBN   978-1-284-09051-2.
  6. ↑ Krebs RE (2006). The History and Use of Our Earth's Chemical Elements: A Reference Guide. Greenwood Publishing Group. p. 80. ISBN   978-0-313-33438-2.
  7. ↑ Mould RF (1993). A Century of X-Rays and Radioactivity in Medicine: With Emphasis on Photographic Records of the Early Years. CRC Press. ISBN   978-0-7503-0224-1.[ page needed ]
  8. ↑ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl: 10665/371090 . WHO/MHP/HPS/EML/2023.02.
  9. ↑ "Barium Swallow". Health Library Guide to the diagnosis, treatment and prevention of conditions from A to Z. Johns Hopkins Hospital. Archived from the original on 28 July 2014.
  10. ↑ "Barium Sulfate". MedlinePlus Drug Information. U.S. National Library of Medicine. 15 July 2016. Archived from the original on 5 July 2014.
  11. ↑ "Choose READI-CAT® 2 Smoothies Oral Contrast for your CT Suite" (PDF). Archived (PDF) from the original on 29 November 2015. Retrieved 23 July 2014.
  12. ↑ Miller RE (February 1966). "Flavoring barium sulfate". The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine. 96 (2): 484–487. doi:10.2214/ajr.96.2.484. PMID   5908404.
  13. ↑ "Contrast Materials". Archived from the original on 22 July 2014. Retrieved 23 July 2014.
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