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A Barium Follow Through is an X-ray imaging procedure used to evaluate the small intestine, especially when investigating symptoms such as chronic abdominal pain, diarrhea, weight loss, or suspected intestinal obstruction or Crohn’s disease. The test begins with the patient drinking a suspension of barium sulfate, a contrast material that coats the lining of the intestines. Unlike the barium meal, which focuses on the stomach and duodenum, the barium follow through is designed to track the passage of barium through the entire small bowel, particularly the jejunum and ileum. After the patient drinks the barium, serial abdominal X-rays are taken at timed intervals (typically every 15–30 minutes) to monitor how the barium moves through the intestines. The radiologist observes the motility, shape, position, and mucosal pattern of the small bowel to identify any abnormalities such as strictures, fistulas, tumors, malabsorption, or inflammatory conditions. This procedure is non-invasive and can take anywhere from 1 to 4 hours, depending on how fast the barium transits through the bowel. The barium follow through is especially helpful in diagnosing diseases that are not easily visible in standard endoscopic procedures. After the exam, patients are usually advised to drink plenty of fluids to help eliminate the barium from their system and avoid constipation.
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