Type:
Audit/Professional Issues
Keywords:
Professional issues, Audit and standards
Authors:
A. Mahajan; Mumbai/IN
DOI:
10.1594/ecr2010/C-3252
Discussion
Although endoscopy is a valuable test for assessing mucosal disease in the GI tract, barium studies have a clear advantage over endoscopy for evaluating submucosal and extrinsic mass lesions and for assessing GI function and motility from the pharynx to the anorectal junction. The barium study is also indispensable for clarifying uncertain findings at endoscopy or CT. If, hypothetically, the barium study was no longer available, these equivocal cases could be major diagnostic dilemmas.
The esophagogram is a safe, noninvasive, and relatively inexpensive global examination for dysphagia (1) that can be used to diagnose a variety of abnormalities, including swallowing dysfunction in place of or in addition to a work-up by a speech therapist (2); tumors, diverticula, or other morphologic lesions in the pharynx as an adjunct to an ear-nose-throat examination (3); esophageal dysmotility in place of manometry
The double-contrast upper GI examination is a safe, inexpensive, and cost-effective test for the work-up of patients with epigastric pain, dyspepsia, bloating, nausea, vomiting, and other upper GI signs or symptoms.
The barium enema is the GI fluoroscopic procedure that has undergone the greatest decrease in volume. Nevertheless, it remains a useful test for abdominal pain, altered bowel habits, or chronic or low-grade GI bleeding due to colonic carcinoma, diverticulitis, inflammatory bowel disease, or other causes.
GI fluoroscopic examinations also have an important role in the evaluation of patients after GI surgery (including, most recently, bariatric surgery) and in the diagnosis of a host of postoperative complications (eg, perforation and obstruction).