GIT (Gastrointestinal Tract)
These are dynamic studies to evaluate the oesophagus, stomach, duodenum, small bowel and the large bowel. Both structure and function is thus evaluated.
Use is made of oral contrast material which is usually Barium. Occasionally water-soluble oral contrast agents are used such as Hexabrix or Gastrograffin are used. This is if there is a suspected abnormal connection between the oesophagus and the airway or if there is a chance of aspiration.
Fluoroscopy is used to obtain multiple images which can be reviewed. Due to the use of x-rays, female patients must make sure they are not pregnant.
Barium Swallow
Swallowing is one of the most complex neuromuscular functions of the body. It involves co-ordination of the mouth, pharynx, larynx and the oesophagus. 3 phases are involved during swallowing – the oral phase, pharyngeal phase and oesophageal phase. The oral phase is voluntary and controlled by the cortex. This phase prepares the bolus of food so that it is swallowable. The pharyngeal phase is involuntary and triggered by the bolus of food contacting the tonsillar pillars and the pharyngeal wall. It involves the high cortical centres, the brain stem centres and cranial nerves V (trigeminal), VII (facial), IX (glossopharyngeal), XI (vagus) and XII (hypoglossal). The oesophageal phase is controlled by the brainstem and myenteric plexus. Food moves down by a peristaltic wave beginning in the pharynx and ending at the lower oesophageal sphincter.
What are the causes?
tructural causes:
- Strictures
- GORD
- Zenkers diverticulum
- Neoplasm
Neurologic causes:
- cerebrovascular accident – stroke; haemorrhage
- Multiple sclerosis
- Cerebral palsy
- Myelomeningocoele
Connective tissue disorders:
- Muscular dystrophy
- Polio
Psychologica:
- Psychogenic dysphagia
Iatrogenic:
- Certain drugs
What is going to happen?
You will be asked to take several mouthfuls of barium and swallow whilst imaging. This will be done in several different positions. No patient preparation is required. A booking is usually not required.
When will I get my results?
After the test, the radiologist may discuss findings with you. The images will be stored on a disc which you can take to your doctor together with the report.
Indications
- Drooling
- Choking
- Nasal regurgitation
- Voice change
- Recurrent pneumonia
- Unexplained weight loss
Barium Meal
A barium meal evaluates the stomach, duodenum and the proximal small bowel. Comment will also be made on the oesophagus.
What is going to happen?
You will be asked to drink a cup of thin barium followed by a sachet of enos. This is done to distend the stomach somewhat and get good coating of the lining of the stomach by the barium. You may be asked to change position and roll over in an attempt to get adequate coating. This is done under fluoroscopy where the passage of the barium can be followed. Representative images are taken and stored. Female patients must be sure they are not pregnant.
When will I get results?
Following the test, the radiologist will look at all the images and then issue a report. All images will be stored on disc which you can take to your doctor.
Indications
To assess inflammation of the stomach lining (gastritis), for chronic disease such as Chron’s disease, to look for stomach and duodenal ulcers, for tumours and to evaluate congenital malformations in children.
Enteroclysis
This is the best investigation to evaluate the small bowel which is inaccessible to alternative modalities such as colonoscopy for large bowel.
What is going to happen?
You will be asked to lie on your side and a rectal examination performed to make sure there are no tumours close to the anal margin. A small tube is gently inserted into the rectum which is secured with a balloon filled with air. Barium is allowed to flow in under gravity and coat the mucosa of the large bowel. Excess barium is then removed and air is gently pumped in to distend the bowel. This may cause some abdominal discomfort with will be relieved by using an intravenous anti-spasmodic drug. Representative pictures are taken.
Indications
To assess inflammation of the stomach lining (gastritis), for chronic disease such as Chron’s disease, to look for stomach and duodenal ulcers, for tumours and to evaluate congenital malformations in children.
Barium Enema
This contrast study will evaluate the large bowel (colon) and the ileo-caecal junction.
What is going to happen?
You will be asked to lie on your side and a rectal examination performed to make sure there are no tumours close to the anal margin. A small tube is gently inserted into the rectum which is secured with a balloon filled with air. Barium is allowed to flow in under gravity and coat the mucosa of the large bowel. Excess barium is then removed and air is gently pumped in to distend the bowel. This may cause some abdominal discomfort with will be relieved by using an intravenous anti-spasmodic drug. Representative pictures are taken.
Indications
Indications include polyps, diverticulae, tumours, strictures and mucosal changes.
Defaecogram
This is an x-ray procedure that shows the rectum and anal canal as they change during defecation.
What is going to happen?
It is a technique in which barium (contrast medium) is introduced into the rectum following a rectal examination. The barium is mixed into a thick paste. The barium is visible in the rectum on x-rays. If the referring doctor suspects an enterocele (an internal small bowel hernia) one will be given 2 glasses of barium to drink 2 hours prior to the procedure. During the test, the patient is asked to empty the rectum whilst sitting on a commode during which x-rays are taken.
Patient preparation:
- Nil.
- If the referring doctor suspects an enterocele, patient will arrive 2 hours before to drink barium to mark the small bowel
When will I get my results?
The images will be stored on a disc which you can take together with a report to your doctor.
Indications
For chronic constipation, rectal prolapse, rectocoele, enterocele and faecal incontinence.