Which is better for finding bleeding in the upper GI: endoscopy or a barium X-ray?
On One Hand: Barium Is Less InvasiveIn a barium X-ray test, the patient drinks a solution of barium and stands in front of a fluoroscope (like an X-ray movie camera). The barium dyes the inside of the GI tract and can pinpoint any abnormalities, holes, weaknesses or cause of bleeding. It is painless (although not tasty) and requires no recovery.On the Other: Endoscopy Can Do MoreAn endoscope is a camera attached to a tiny flexible tube inserted down the esophagus. This requires light sedation so the patient doesn’t gag, and sometimes to promote amnesia. Although it’s not painful, it can be uncomfortable, and numbing spray is used. The benefits of endoscopy are the doctor can directly see the inside of the GI tract, and tools can go through the tube to perform biopsies.Bottom LineThe less-invasive test (barium) should be tried first, but if it is inconclusive, or more intense probing is needed, endoscopy can diagnose the problem and possibly fix it in the same procedure.
