[Dysphagia] Food and barium

[eripley at yahoo.com (Irene Campbell-Taylor)]

I continue my search for a reason for mixing food with barium for VFSS. Barium alone, if aspirated is innocuous but, if, as is unfortunately too often the case, VFSS is performed to look for aspiration which is, logically, at least potential in the clinician?s mind, why risk the aspiration of a harmful substance i.e. food, when barium alone is sufficient and harmless as well as being the substance used in all available research on swallowing? Please see the following:

Sutton, D,1980 A textbook of Radiology & Imaging, Churchill Livingstone, London

A barium sulphate suspension in water is the universal contrast medium used for examination of the upper gastrointestinal tract. A simple barium sulphate/water mixture has several undesirable properties such as a tendency to sediment and unpalatability. Consequently many commercial barium meal preparations have been developed to obviate these unfavourable features.

Aspiration - Aspiration of small volumes of barium sulfate suspension is usually incidental. The barium is eliminated by coughing and the mucocilliary apparatus. The remainder of the barium is removed by macrophages and may accumulate in the tracheobronchial lymph nodes which will then appear opaque. Aspiration of large volumes of barium can cause suffocation and suction may be necessary to remove the barium. If gastric contents or other material is aspirated, then pneumonia may result. Often, this is treatable with antibiotics. Aspiration of nonionic, iodinated contrast material may lead to pulmonary edema.



Dr I Campbell-Taylor
Clinical Neuroscientist
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