7 Contemporary radiological examination of the upper gastrointestinal tract

Barium and endoscopy both have advantages. Endoscopy not only gives you direct visualization but also the ability to biopsy tissue. It does not give you the ability to determine the exact anatomy or the gross appearance of a lesion. Barium on the other hand gives you a dynamic examination which is particularly useful for the assessment of swallowing disorders and oesophageal motility. When the pharynx and oesophagus are not of prime concern and cost is not a problem then endoscopy is the examination of choice. It has been shown that dyspeptic patients who have had both examinations have a definite preference for endoscopy (Stevenson et al, 1991). As endoscopy requires minimal physical effort, it is also a preferable examination for the unwell patient.