Decision Assist

GI tests


The purpose of this tool is to help you decide whether or not to have an upper or lower GI test. When making a decision like this, you must balance:

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. There is usually no exact “right” or “wrong” answer.

Your physician may make certain recommendations to you. However, the final decision about whether to have these tests rests with you.

What is the test?

An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. X-rays occur after the patient has swallowed a barium suspension (contrast medium) – usually in the form of a milk shake. A lower GI test examines the large intestines. In this test, barium is placed into the rectum and travels upward into the rest of the colon.

Lower digestive anatomy

X-rays are a form of electromagnetic radiation, like light, but strong enough to penetrate the body to form an image on film. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray. Barium is very dense and will appear white on the x-ray film.

Click the icon to see an illustration detailing x-rays.

The purpose of an upper GI series is to detect anatomic or functional problems in the esophagus, stomach, and small intestine. A lower GI series (also called a barium enema) can detect colon cancer. A barium enema may also be used to diagnose and evaluate the extent of inflammatory bowel diseases.

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Review Date: 9/19/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

  • Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 136.
  • Rosman AS, Korsten MA. Meta-analysis comparing CT colonography, air contrast barium enema, and colonoscopy. Am J Med. 2007 Mar;120(3):203-210.e4. Review.
  • Smith RA, Cokkinides V, Brawley OW. Society Guidelines and Cancer Screening Issues. Cancer Screening in the United States, 2008: A Review of Current American Cancer. CA Cancer J Clin. 2008;58;161-179; originally published online Apr 28, 2008.
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