a. General. The digestive tract can be outlined by x-rays by utilizing the administration of a contrast medium.

The contrast medium is swallowed by the patient in order to visualize the upper GI tract. These procedures are referred to as “barium swallow,” “upper GI,” or “small bowel follow-through.” To visualize the lower GI tract, the contrast medium is instilled rectally. This procedure is called a “barium enema.”

b. Pre-Procedural Nursing Implications. 

(1) For upper GI examinations, the patient is normally held NPO after midnight the day before the exam in order to empty the upper GI tract. Additionally, gum chewing and smoking should be discouraged the morning of the exam, as this stimulates gastric action.

(2) For lower GI tract examinations, the patient’s large intestine must be free of stool. This is normally accomplished through the use of laxatives and cleansing enemas. The patient is held NPO after midnight the day before the exam.

(3) The patient must be educated about the procedure, the significance of the preparation, and any significant post-procedural sequelae.

(4) Many procedures require that the patient sign a permit. Check with your local military treatment facility (MTF) standard operating procedure (SOP).

c. Post-Procedural Nursing Implications. 

(1) Many patients experience constipation as a side effect of the contrast medium. If so, mineral oil or a laxative may be required to relieve constipation.

(2) Observe the patient for any signs of abdominal or rectal discomfort. Check vital signs in accordance with (IAW) the ward SOP.

(3) Resume diet and medications as directed by ward SOP.