[Dysphagia] barium and gastrographine

[pressmah at sjhmc.org (pressmah@sjhmc.org)]

The radiologists that I have worked with have said that gastrographen was
MUCH worse for the lungs

-----Original Message-----
From: Sarah Ware [mailto:skware1@msn.com]
Sent: Wednesday, November 02, 2005 9:49 PM
To: Patricia and David; dgrabo@nycap.rr.com
Cc: dysphagia@b9.com
Subject: Re: [Dysphagia] barium and gastrographine


Do you think there is a possibility of some sort of tracheoesophageal
fistula which could cause some barium to be transferred from the esophagus
into the trachea well below the TVC?  Just a thought!
  ----- Original Message ----- 
  From: dgrabo@nycap.rr.com<mailto:dgrabo@nycap.rr.com> 
  To: Patricia and David<mailto:guapa@otenet.gr> 
  Cc: dysphagia@b9.com<mailto:dysphagia@b9.com> 
  Sent: Wednesday, November 02, 2005 4:55 PM
  Subject: Re: [Dysphagia] barium and gastrographine


  I don't know anything about gastrographine but I can tell you about an 
  interesting VFSS I did last week.  An 87 year old lady was referred to 
  me by her GI MD for "transfer dysphagia."  Apparently during a(n) UGI 
  on 9/9/04 she aspirated.  She was seated upright to complete the 
  testing.  A recommendation was made at that time to have a "cookie 
  swallow" (let's not even go there!) to investigate why she aspirated 
  during the UGI (perhaps lying down and being told to drink a lot of 
  nasty liquid quickly?!??? - god forbid we use any common sense!).  
  Anyway a year and a month later (never mind the ridiculous 
  untimeliness of this referral!!) she comes to me with absolutely no 
  complaints about anything, much less swallowing.  As will come as no 
  surprise, when seated upright and given small and moderate intakes of 
  thin liquid barium, no aspiration occurred.  She was then turned AP to 
  look at the flow of liquid through the esophagus.  When turned AP her 
  lungs were chuck full of barium!!!! The Radiologist agreed that she 
  did not aspirate during the current test and since she has had no 
  other barium tests since 9/9/04, he felt that the barium has been 
  sitting in her lungs for over a year.  She is not short of breath, no 
  incidents of  pneumonia, no coughing, nothing.  So, in this field of 
  one study, I'd say the barium has had not led to any resultant lung 
  problems.  

  ----- Original Message -----
  From: Patricia and David <guapa@otenet.gr<mailto:guapa@otenet.gr>>
  Date: Wednesday, November 2, 2005 5:10 pm
  Subject: [Dysphagia] barium and gastrographine

  > One of the doctors I work with has mentioned that barium should no
  > longer be used in VFSS because of the effects to the lungs it has if
  > aspirated, and gastrographine should be used instead.  Could anyone
  > comment or give me titles of articles I could look  up.
  > 
  > Thank you
  > 
  > Patricia Giannika
  > 
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