Pain with Upper GI barium swallow? - Digestive Disorders Message Board

MeghanR · 04-21-2003, 09:34 PM

Hi all,

Quick question for you today...I am also posting this on the IBS board.

I went in today for an Upper GI with lower bowel follow-through. At the beginning of the procedure, they gave me the gas-producing crystals...no problem there. Yet, while swallowing the thickest barium solution, I quickly became quite nauseous and was in great fear of vomiting all over their nice medical equipment.

I was able to keep it down, but within half an hour, I found that the barium swallow actually *duplicated* my as-yet undiagnosed abdominal pains. My upper abdomen was cramping horribly, and I was doubled over in pain, unable to find a comfortable position. When I had to lay on my stomach for a follow-up x-ray, I yelped out in great pain.

Half an hour to an hour later, the severe pain had moved to my lower abdomen. By an hour later, I was feeling relatively well again, although I have been very sore all day & night, with occasional short-lived stabbing pains.

While having the final x-rays taken, the tech. manipulated my bowels through my abdomen and I could do nothing more than close my eyes and use (what I would guess would be) lamaze breathing methods to get through the pain.

I have been unable to find anything on the internet about this phenomenon...in fact, I have found multiple references to how little discomfort one should feel during the procedure. The techs at the hospital were relatively unsympathetic to my pain, not really understanding why I was feeling what I was feeling.

Previous blood tests, abdominal CT and abdominal ultrasounds have all been "normal". An endoscopy did find a few gastric polyps and a large sliding hiatal hernia.

Without being able to hear of results for several days, I'm curious now if this sounds to you all like a motility disorder (i.e. IBS). Has anyone ever *heard* of such a thing?

rach923 · 05-01-2003, 07:43 PM

hey..i had this test done a couple of years ago, but i did not have any pain...however, the first portion of my drinking liquid was done through a feeding tube as i had one in for nutrition at the time. however, i know the pain you are feeling...although i usually experience it in my lower abdominal area...do you have a GI doc??? well, i guess so, since you had this test!! when i complained of these symptoms, they were linked to IBS, however, i also had problems with loose bowels simultaneously...anyway...my doc put me on bentyl...and non-sedative abd. pain reliever....WORKS WONDERS!!! however, i was using it alot (about 2 times every three days) so he switched me to 2x a day levbid...it works just as well, keeps symptoms at bay, although i do have difficulties occasionally...don't know if this is your problem, but hope this info helps!

rach

lckwp · 05-02-2003, 05:39 AM

MeghanR:

I can relate completely to this!

I have had right side abdominal pain... which started out as episodic quite awhile ago (up to 2 years ago, and gradually getting more often). Then I started to have a uncomfortable feeling in my right abdomen as early as January. By February, the uncomfortableness was daily. By March the uncomfortableness was PAIN. And it got worse through March.

And still my doctor was insisting that it was still just the flu - because I'd been for bloodwork & a urine test, and nothing showed.

By the 3rd week of March, I was FINALLY sent for an abdominal ct scan with contrast.
At the scan, I was forced to drink 2-1/2 large soft drink containers full of what I can only describe as Kool-Aid From Hell. It tasted like cherry flavoured bile!
Every sip I took of this drink made me feel like throwing up! It took me an hour & a half to drink all this stuff. And during that time, my right side abdominal pain increased to levels I hadn't known before, and I was completely uncomfortable, to the point of nearly being in tears!

I too felt that the people at this testing center were either unsympathetic OR they didn't understand just how sick I felt and how much pain I was in.

The pain stayed at a high level for days afterwards! I was so scared!
BUT... I assumed that because the test CAUSED the pain to get so much worse - I figured that test would definitely show what's wrong with me and causing me pain!

Not so. The results of the cat scan showed nothing to explain this pain!

Then, the next week I was sent for a gallbladder sonogram ultrasound. During that test, I was in such pain while they poked that thing around my right side, that I WAS crying - tears running down my face. The technician was actually apologizing she felt bad that she was hurting me!

Again I was hopeful that since the test caused the pain, maybe it would see what was causing the pain!
And yet, that test too showed only an "abnormality" - which the gastroenterologist who ordered the test said that couldn't explain the pain I described!

Then, the following week I was sent for a gallbladder CCK HIDA pipida scan. That didn't worsen or lessen the pain any. But actually, afterwards, I felt a little better in general (like less foggy maybe). I'm now under the suspicion that it had something to do with having an IV for a few hours - perhaps that cured my dehydration - I don't know.

The next day I went for an Upper GI & Lower Bowel series. It was difficult to drink those drinks. But the pain wasn't nearly as bad as the ct scan 'contrast drink' - mainly because I wasn't forced to drink a whole lot of the barrium drink.

However, towards the end of the testing, my lower right side pain started building a lot!
I could FEEL the barrium sitting in my lower right abdomen.
And while the radiologist was holding this thing right over my lower right side pain I heard him say to the technician "Do you see that constricting?"
I immediately told him I was having pain right there, right then. He asked me questions about the surgery I had in that area.
YET, my GI test came back normal!

I have also been able to find no explanation as to why these tests would make my pain worse, cause the pain. And even more, it's shocking that since they caused the pain, they didn't show what's causing the pain.

But I just wanted to post so you know you're NOT alone. These tests caused my pain to be worse! And just because the doctors I've seen thought that was "weird" or "unheard of", doesn't mean I'm the only one who's had this happen! Obviously, if it happened to you too...

But I hope you're luckier than me, and that the test that caused your pain actually shows what's wrong with you!

CrohnieToo · 05-02-2003, 06:20 AM

What surgery did you have in the lower right quadrant of the abdomen? Appendectomy? Bowel resection?

Irritable bowel syndrome is not at all uncommon after one has had abdominal surgery. A mild case of IBS might not really bother you much or often at all - but do something to tick the bowel off or irrtate it and the IBS doesn't seem mild at all, it can get downright vicious at the time.

That lower right quadrant where the terminal ileum runs into the ileocecal valve which runs into the cecum (appendix runs off the bottom of the cecum) and the cecum runs into the ascending colon is a favorite target of Crohn's disease. Crohn's can be difficult to detect in the early stages. It can also be present for quite some time causing no symptoms at all. In addition Crohn's can affect the GI tract anywhere from the mouth to the anus.

It may be that you are sensitive to barium. That really isn't an allergy in the classic sense of the term but I would think that a sensitivity to it could be a possible cause of the pain you've described. For instance, novacaine is supposed to be a pain killer. I am not allergic to novacaine but give me an injection of novacaine and the site will ACHE for days afterwards. Go figure.

Ickwp, one of your tests showed an "abnormality" and another produced some "constricting" and yet both tests were "normal"??? Not being particularly trustful of doctors I would go to the facility where the procedures were done and request a copy of the procedure reports to read for myself. You might also want to request the actual films (if any) as well and take all to someone else for a second opinion.

As far as blood tests: C reactive Protein and ESR (Sedimentation rate) are the two blood tests to indicate inflammation. But they aren't 100% You can have active Crohn's disease, for instance, which is a chronic inflammation of the bowel, and still NOT have a high Sed rate or CRP.

All of these tests are only as good as the person interpreting them in conjunction with your symptoms.

Some facilities the techs are doing the barium swallow series and the radiologist just reads the films and then interprets them. The good facilities the radiologist performs the procedures or is watching them in real time so that if something catches his/her eye, a more concentrated effort at viewing that area can be done.

A pathologist not experienced in reading IBD biopsies can miss the Crohn's or UC abnormalities. A radiologist not experienced w/IBD could miss IBD abnormalities (IBD = Inflammatory Bowel Disease = Crohn's disease or Ulcerative Colitis), etc.

Before giving up and living w/this pain, if your insurance allows it, head for the nearest teaching medical school w/a good gastroenterology department.

In the midwest, Mayo Clinic, Rochester, MN, comes to mind; as does Cleveland Clinic in OH, Northwestern in Chicago. There's a good gastro clinic in or near Columbus, OH I've forgotten the name of.

Good luck and God bless!

lckwp · 05-02-2003, 07:04 AM

I had a tumor that was on my ovary & twisted it - the ovary & tumor were removed.

The common bowel problem after abdominal surgery that you describe is *NOT* IBS - it's intestinal adhesions which cause bowel obstruction or partial bowel obstruction.
And yes, I do suspect that could be my problem.
And apparently adhesions NEVER show up on any of these tests... so people often suffer with partial bowel obstructions for a LONG time being told they have IBS, when really, their bowels are being strangled, but the doctors don't realize it because they can't see it on their tests - and these days you have to jump through insurance hoops to get exploratory surgery. (Which is the only way apparently to diagnose adhesions.)

Sorry if I sound a little brusque about this... But it's just that I've heard SO MANY stories now of women with adhesions who were told they had IBS - and then wound up months later with total bowel obstruction and having to have parts of their intestines taken out! (When this could've been prevented if the doctors weren't so quick to say IBS and fix the adhesions early!)

I HAVE heard of people being allergic or sensitive to barrium.
But how about the contrast drink for the cat scan? That wasn't chalky at all - it was something completely different - and that made me MUCH sicker and MUCH worse pain than the barrium.
So in my case, I don't think it's barrium sensitivity for that reason.

And yeah, the gallbladder sonogram ultrasound showed an abnormality - but it was "merely a polyp" which I'm told can't account for my pain.

ANd yeah, I did request the actual written results of my tests.

Even worse than NO MENTION of "constricting" AT ALL on my GI report... I can't even BELIEVE that the radiologist didn't bother to mention that!
And yeah, the radiologist was doing parts of the scans too... You would think he would've made a note of that constricting!
Considering I was having the pain right then, and he saw constricting - that certainly sounded important to me!

But I was told my CCK HIDA scan was "normal". And indeed, in the written report it says "within normal range".
But it also lists my ejection fraction at 35% - which from everything I've read now suggests that 35% is NOT really normal & healthy at all!

And yeah, I'm definitely going for more opinions. No doubt about it. Unfortunately I live in an area where there's an extreme doctor shortage. So I have to wait yet another 2 weeks in pain before my next doctor's appointment. And probably 2 weeks after that for more tests, and probably 2 weeks after that before I'm told once again they don't know what's wrong with me!
I was told to be glad I don't need to see a neurologist - apparently the average waiting time for an appointment with one of them in this area is FIVE MONTHS.

Unfortunately I have an HMO type insurance, and I can't see any doctors without the permission of my primary care physician. I've switched 3 times now, trying to get one that will facilitate me going to the right specialists - and more specialists for more opinions.
It's like pulling teeth to get primary care physicians to refer to a specialist - even when they can't figure out what's wrong themselves!