[Dysphagia] barium and gastrographine

[dgrabo at nycap.rr.com (dgrabo@nycap.rr.com)]

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>
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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