To diagnose hiatal hernia, diverticula, and varices

To detect strictures, ulcers, tumors, polyps, and motility disorders

Make sure that the consent form is signed by the child’s parents or legal guardians.

Explain that the test evaluates the function of the pharynx and esophagus.

Maintain the child on a nothing-by-mouth status beginning at midnight before the test. (For an infant, delay feeding to ensure complete digestion of the barium.)

The child may be given a restricted diet for 2 to 3 days before the test.

Describe the test, who will perform it, and where it will take place.

Describe the milk shake consistency and chalky taste of the barium preparation. Although flavored, it may be unpleasant to swallow.

Explain to the child that he’ll first receive a thick mixture, then a thin one; he must drink 12 to 14 oz (355 to 414 ml) during the examination.

Inform the child that he’ll be placed in various positions on a tilting X-ray table and that X-rays will be taken.

Emphasize the importance of remaining still during the X-rays.

Reassure the child about safety precautions.

Withhold antacids, histamine-2 receptor antagonists, and proton pump inhibitors, if gastric reflux is suspected.