A diagram showing a person's esophagus, stomach and small intestines.
If you have additional questions or concerns regarding the UGI with small bowel series exam, please contact the pediatric imaging child life specialist from the John Hancock Child Life and Wellness Services at MGHfC at 617-724-1153.

What is an upper GI (UGI) with small bowel series?

An upper gastrointestinal (UGI) with small bowel series is an X-ray exam that shows the structure of the upper gastrointestinal tract, the part of the body that food passes through as it is digested, and the entire small intestine. The exam will allow the radiologist to assess how the upper gastrointestinal tract, which includes the esophagus, stomach, small intestine and small bowel, is working. This exam will typically last two to three hours, sometimes more.

Why does my child need a UGI?

A UGI with small bowel series exam is used to help find the cause of problems such as swallowing difficulties, unexplained vomiting, abdominal discomfort and severe indigestion. This exam will view your child’s entire upper gastrointestinal track and small bowel.

Who performs the examination?

A pediatric radiologist and a pediatric trained X-ray technologist will assist you and your child during this procedure. At times, a child life specialist will also be present during your child’s procedure.

How can I prepare my child for the UGI?

Your child’s age will determine how you will prepare him/her. Toddlers and preschool-aged children require a very simple explanation of the procedure just before the exam begins. School-aged children and adolescents require a more detailed explanation of the exam which should be done one to two days in advance. This will allow your child time to ask any questions he/she might have prior to the exam. Above all, it is important to be completely honest with your child about his/her exam.

How is a UGI performed?

  • Your child will need to have an empty stomach for this exam. You will receive eating instructions and restrictions from the doctor who ordered the UGI exam prior to the date of your child’s exam
  • A pediatric X-ray technologist or a child life specialist will bring you and your child into the fluoroscopy room. The X-ray technologist or the child life specialist will explain the exam to you and your child
  • Your child will be asked to change into a hospital gown. Once changed, your child will be helped onto the fluoroscopy table
  • Your child will be given a thick, white liquid called barium to drink through a straw or bottle. This liquid is what allows the radiologist to see the gastrointestinal system more clearly. Because barium does not always have a pleasant taste, your child will be allowed to chose a chocolate or strawberry flavoring to add to the barium to make it taste a little better
    If your child has food allergies it is important to inform the radiology team prior to the exam.
  • The radiologist will move the fluoroscopy camera over your child. The camera will come close to, but not touch, your child. The radiologist will begin to take X-ray pictures as the barium liquid is swallowed and passes through the esophagus into the stomach. Your child will be asked to continue to drink the barium liquid while the radiologist takes the X-ray pictures. Your child will be asked to roll from side to side while X-ray pictures are taken. The X-ray pictures will allow the radiologist to watch the progress of the barium through the gastrointestinal system
  • When the barium liquid empties from the stomach and the radiologist has seen enough of it pass through the small intestine, the UGI is complete and the small bowel series will begin.
  • Because the small bowel series tracks the progress of the barium liquid through the entire small intestine, it usually takes two to three hours or more to complete. Your child may be given another cup of the barium liquid to drink. Your child will need to finish this cup of barium as quickly as possible, but typically within 30 minutes.
  • You and your child will then be moved back to the play room. The X-ray technologist will take your child to the X-ray room every 30 minutes for a series of X-ray pictures of your child’s abdominal, or belly, area. An abdominal X-ray will be taken every 30 minutes until the barium liquid has passed through the entire small intestine.
  • The radiologist might need to press on your child’s belly with a very soft balloon at the end of the study. This helps to get better pictures of the small intestine. The balloon does not cause any discomfort.
  • Once the exam has been completed, your child may return to his/her diet as instructed by your doctor. It is a good idea to increase your child’s fluid intake for the day

What can I do to help my child during the procedure?

You will be present during your child’s entire procedure.* It is important that you try to remain calm throughout the exam. For some children, having a parent with them is comforting enough. Others may require additional support. As a result, the radiology team has other distraction items that can be used to help your child during the procedure.

*Women who are pregnant will not be allowed in the fluoroscopy room. (Please note that other children will not be allowed in the fluoroscopy room.)

What happens once the UGI is done?

The results of your child’s exam will be sent to the doctor who requested the exam. Typically your doctor will receive the results within one to two days of the exam or sooner. Critical results are communicated to the ordering doctor shortly after the procedure has been completed.

Rev. 6/2017. This document is intended to provide health related information so that you may be better informed. It is not a substitute for a doctor's medical advice and should not be relied upon for treatment for specific medical conditions.