Barium sulfate suspension, often simply called barium, is a

contrast agent A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radiop ...

used during

X-rays An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

. Specifically it is used to improve visualization of the

gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...

(esophagus, stomach, intestines) on plain X-ray or

computed tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

. It is taken by mouth or used

rectally The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult hu ...

. Side effects include

constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The Human feces, stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the ...

diarrhea Diarrhea (American English), also spelled diarrhoea or diarrhœa (British English), is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration d ...

appendicitis Appendicitis is inflammation of the Appendix (anatomy), appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and anorexia (symptom), decreased appetite. However, approximately 40% of people do not have these t ...

, and if inhaled inflammation of the lungs. It is not recommended in people with

intestinal perforation Gastrointestinal perforation, also known as gastrointestinal rupture, is a hole in the wall of the gastrointestinal tract. The gastrointestinal tract is composed of hollow digestive organs leading from the mouth to the anus. Symptoms of gastroi ...

bowel obstruction Bowel obstruction, also known as intestinal obstruction, is a mechanical or Ileus, functional obstruction of the Gastrointestinal tract#Lower gastrointestinal tract, intestines which prevents the normal movement of the products of digestion. Ei ...

Allergic reactions Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermatitis, alle ...

are rare. The use of barium during

pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...

is safe for the baby; however, X-rays may result in harm. Barium sulfate

suspension Suspension or suspended may refer to: Science and engineering * Car suspension * Cell suspension or suspension culture, in biology * Guarded suspension, a software design pattern in concurrent programming suspending a method call and the calling ...

is typically made by mixing

barium sulfate Barium sulfate (or sulphate) is the inorganic compound with the chemical formula Ba SO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs in nature as the mineral barite, which is the main commercial source of ...

powder with water. It is a non-iodinated contrast media. Barium sulfate has been known since the

Middle Ages In the history of Europe, the Middle Ages or medieval period lasted approximately from the 5th to the late 15th centuries, similarly to the post-classical period of global history. It began with the fall of the Western Roman Empire and ...

. In the United States it had come into common medical use by 1910. It is on the

World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...

. Some versions contain flavors to try to make it taste better.

Medical uses

Barium sulfate Barium sulfate (or sulphate) is the inorganic compound with the chemical formula Ba SO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs in nature as the mineral barite, which is the main commercial source of ...

suspensions are provided by a radiologist or radiographer in advance of, or during a

CT scan A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

fluoroscopic 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 t ...

study to allow for better visualization of the

, such as in upper or

lower gastrointestinal series A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs (X-ray pictures) are taken while barium sulfate, a radiocontrast agent, fills the colon via ...

. In

upper gastrointestinal series 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 bariu ...

, the patient is instructed to take

nothing by mouth Nothing by mouth is an American medical instruction meaning to withhold food and fluids. It is also known as nil per os (npo or NPO), a Latin phrase that translates to English as "nothing through the mouth". Nil by mouth is the term used in the UK ...

, which means to abstain from eating and drinking (

fasting Fasting is the act of refraining from eating, and sometimes drinking. However, from a purely physiological context, "fasting" may refer to the metabolic status of a person who has not eaten overnight (before "breakfast"), or to the metabolic sta ...

), 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 Defecation (or defaecation) follows digestion and is the necessary biological process by which organisms eliminate a solid, semisolid, or liquid metabolic waste, waste material known as feces (or faeces) from the digestive tract via the anus o ...

, so extra fluid intake helps prevent

, which is a possible side effect (see Johns Hopkins Medicine Health Library for an example of a possible patient education instruction sheet).

Side effects

Side effects include

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...

, a feeling of weakness, pale skin, ringing in the ears, constipation, and vomiting.

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 A milkshake (sometimes simply called a shake) is a sweet beverage made by blending milk, ice cream, and flavorings or sweeteners such as butterscotch, caramel sauce, chocolate syrup, or fruit syrup into a thick, sweet, cold mixture. It may ...

. Some patients may experience the texture as a chalky liquid, similar to

calcium carbonate Calcium carbonate is a chemical compound with the chemical formula . It is a common substance found in Rock (geology), rocks as the minerals calcite and aragonite, most notably in chalk and limestone, eggshells, gastropod shells, shellfish skel ...

containing liquid antacids and with a slight medicinal taste. 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.

References

{{Authority control Radiocontrast agents Wikipedia medicine articles ready to translate World Health Organization essential medicines