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08/06/2010 11:30 PM

Esophagram Barium Swallow Study

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Esophagram Barium Swallow Study

What is a esophagram barium swallow study?

How do you get ready for the test?

What happens during a barium swallow study?

What does barium taste like?

How long will the test take?

How do you get to your test?

What is a esophagram barium swallow study?

The barium swallow is a study that is completed in radiology. The test evaluates the esophagus. The esophagus is the tube that goes from the throat to the stomach.

This will help your doctor identify possible problems and the best treatment. This study is sometimes called an Esophagram.

How do you get ready for the test?

•Adults - No solid foods 4 hours prior to the procedure. Adult patients may be on a clear liquid diet 2 hours prior to the procedure. Give medicines at the regular times with water anytime.

•Children - No solid foods 6 hours prior to procedure. A clear liquid diet anytime prior to the procedure is fine. Give medicines at the regular times with water.

•Infants - Do not eat or drink 4 hours prior to procedure. Your child should be thirsty and ready to drink upon arrival for the barium swallow study. Bring a special cup or sippy cup your child likes to use. If your child drinks best from a bottle, bring a bottle.

•Give medicines at the regular times with a small amount of water.

•Wear clothing that you can remove from the waist up. You will be given a gown to wear.

•The esophagram barium swallow uses x-rays and anyone who is pregnant cannot be in the room during the x-ray.

What happens during an esophagram barium swallow study?

Before the study you/your child will need to remove all clothing and jewelry from the waist up. You will be given a hospital gown to wear.

The study is completed in a radiology (x-ray/fluoroscopy) room.

If a child is having the barium swallow, a family member or caregiver will be encouraged to stay in the x-ray room to make it easier for the child.

The radiologist operates the fluoroscopy equipment and takes images of the esophagus and provides a medical diagnosis for your physician.

You/your child will be asked to drink 1 to 2 cups of barium. The barium is a contrast material that makes liquids show up on the image-screen as gray or black. You/your child will drink the barium while standing up and while lying down.

If you have any questions or don't understand the instructions please ask.

What does barium taste like?

Barium is heavy and has a chalky taste. Children and adults may dislike the taste.

Flavors may be added to make the barium pleasant tasting. Children under 12 months often like the taste of barium.

What should you do after the test?

Barium rarely causes any problems. It passes through the digestive system. Drink extra fluids for 12 to 24 hours after the study.

If your/your child becomes constipated after the study, drink more liquids and eat more fruit. If the constipation continues, talk with your doctor.

How long will the test take?

The barium swallow study will take about 30 minutes. Some of the time is taken preparing for the study.

How do you get to your appointment?

Your appointment is in radiology. Radiology is in on the third floor of the Smith Building. On the day of your test, first report to the Admissions Desk just inside the Main Entrance. Admissions will direct you to the appropriate location for your test.

If you have questions, or will not be able to make your appointment, please call: 303-398-1611.

Get directions to and see a campus map of National Jewish Health.

This information has been approved by John Newell, M.D. and Will Cook, R.T., M.A.

(January 2010).

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08/17/2010 12:09 AM
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No Significant Esophageal Cancer Risk From Osteoporosis Drug: Study

Analysis also finds no evidence of substantial gastric cancer risk from oral bisphosphonates

URL of this page: fullstory_102025.html (*this news item will not be available after 11/08/2010)

By Robert Preidt

Tuesday, August 10, 2010

TUESDAY, Aug. 10 (HealthDay News) --

People who take oral bisphosphonate drugs to prevent or treat osteoporosis are not at a significantly increased risk for esophageal or stomach cancer, according to an analysis of more than 80,000 patients in the United Kingdom.

The use of oral bisphosphonates has increased dramatically in recent years in the United States and other Western countries, and some recent reports have suggested a link between the drugs and esophageal cancer.

In the study, researchers analyzed data from 41,826 women and men, average age 70, who took oral bisphosphonates between January 1996 and December 2006, and a control group of an equal number who didn't take the drugs.

(Eighty-one percent of the participants were women.)

During an average follow-up of about 4.5 years, there were 37 cases of stomach cancer and 79 cases of esophageal cancer diagnosed in the bisphosphonate group,

compared with 43 cases of stomach cancer and 72 cases of esophageal cancer after 4.4 years in the control group, the investigators found.

"We found no evidence for a substantially increased risk of esophageal (or gastric) cancer in persons using oral bisphosphonates," reported Chris R. Cardwell, of Queen's University, Belfast, and colleagues.

"These drugs should not be withheld, on the basis of possible esophageal cancer risk, from patients with a genuine clinical indication for their use," they concluded.

The study findings are published in the Aug. 11 issue of the Journal of the American Medical Association.

SOURCE: JAMA/Archives journals, news release, Aug. 10, 2010


Copyright (c) 2010 HealthDay. All rights reserved. fullstory_102025.html

08/17/2010 08:08 AM
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I had a barium swallow study on tilt table and x-rays..I threw up the barium all over myself EVERY time I had to try n swallow it due to a terrible problem I had...

They found NO evidence of ANY problems....until....I had surgery and they found I had a pretty bad hiatal hernia....

THEN a few months later with bleeding I had a scope done and found DIVERSTICULITIS A N D DIVERSTICULOSIS A N D sever precancerous polyps.

I really was NOT impressed with the barium swallow with x-rays.

I don't know about anyone else but I would not have JUST this study without something else to followup.

08/18/2010 01:14 AM
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thanks for your personal feedback; these tests are NOT 100% RELIABLE! so glad you checked into other things and they caught it PRECANCEROUS.

i have precancerous colon polyps; going every 5 yrs; now it will be 3 yrs since they continue to plague me.

mom died 20 yrs. ago from a rare cancer ... carcinoid syndrome tumor cancer.

again, thanks for sharing tara Smile hugs/kisses my friend for all you have been thru.

bettyg, iowa leader

08/18/2010 01:40 AM
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I have to think that all of those infections and polyps are lyme related as well.

08/19/2010 03:00 AM
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SWALLOWING..Clinical, Economic Costs of Dysphagia Are High

By Nancy Walsh, Staff Writer, MedPage Today

Published: August 17, 2010

Reviewed by

Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and

Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Action Points

■Explain to interested patients that dysphagia is not only associated with longer hospitalization, mortality, and increased hospital costs -- but also consequences such as malnutrition and social isolation.

■Note that the authors of this database review recommend more attention to the diagnosis and consequences of dysphagia.

Dysphagia among hospitalized patients -- particularly the elderly -- not only lengthens hospital stays and increases the risk of dying, but also carries significant economic burdens.

Data analyses of more than 77 million hospitalizations in 2004 and 2005 revealed, for example, that among patients undergoing inhospital rehabilitation,

the adjusted rate ratio for mortality associated with dysphagia was 13.7 (95% CI 3.5 to 54.5, P<0.001), according to Kenneth W. Altman, MD, PhD, of the Mount Sinai School of Medicine in New York City, and colleagues.

Mortality risk was also elevated in patients with coronary atherosclerosis and dysphagia, with an age- and sex-adjusted rate ratio of 2.6 (95% CI 1.2 to 5.6), Altman and co-authors reported in the August Archives of Otolaryngology–Head & Neck Surgery.

The study also found that hospital stays among patients with difficulty swallowing were almost double that of patients without dysphagia -- with an estimated cost per year topping $547 billion.

With the goal of quantifying the potentially profound consequences of patients having difficulty swallowing -- from malnutrition to social isolation --

Altman and colleagues obtained data from the 2004 and 2005 National Hospital Discharge Survey (NHDS), a sampling survey conducted by the National Center for Health Statistics.

Among more than 77 million hospitalizations during the study period, 0.35% (271,983) were associated with dysphagia.

The rate of hospitalizations associated with trouble swallowing rose to a rate of 0.73% for patients 75 years and older -- more than twice the national average for all age groups.

The researchers identified 20 major diseases associated with dysphagia, with the most common being:

Fluid and electrolyte disorders, 17.5%

•Disease of the esophagus, 15.1%

•Ischemic stroke, 14.8%

•Aspiration pneumonia, 12%

Compared with cases without dysphagia, cases with dysphagia were significantly associated with:

Aspiration pneumonia, RR 9.1 (95% CI 7.5 to 11.2, P<0.001)

•Ischemic stroke, RR 5.1 (95% CI 4.2 to 6.1, P<0.001)

•Parkinson's disease, RR 4.5 (95% CI 3.2 to 6.2, P<0.001)

Rate ratios also were elevated twofold in patients with hemorrhagic stroke, stomach and esophageal disorders, and Alzheimer's disease, as well as in those requiring rehabilitation.

In addition, significant associations with dysphagia were seen with several accompanying conditions, including hemiplegia and hemiparesis (RR 17.2), dyspnea (RR 3.2), and mental disorders (RR 2.7).

Overall, the median number of days patients spent in the hospital was 4.04 in patients with dysphagia compared with 2.4 in those without -- a 40.6% increase.

The greatest increase in hospital time was for patients with hemorrhagic stroke, at 10.55 days for those with dysphagia compared with 4.74 days for those without.

Applying measurement techniques used to calculate costs accruing from community-acquired pneumonia, Altman and colleagues estimated that dysphagia extended the average length of a hospital stay by 1.64 days.

This would result in an additional 223,027 hospital days each year, and an estimated overall cost of $547,307,964.

The authors suggested that the true economic impact would be even higher, because costs incurred from dysphagia are likely to be greater than those associated with community-acquired pneumonia, and the 0.35% rate of dysphagia among all hospitalizations is likely to be a "gross underestimate."

They noted several reasons for under-recognition of dysphagia among hospitalized patients in the NHDS data, including mild symptoms that might not be noticed or documented by physicians and improper coding at discharge.

Strengths of the study include the size and comprehensiveness of the NHDS survey, and although the data do not determine causality, they can reveal significant associations.

But the data can be subject to non-sampling and measurement errors, according to the authors.

"We recommend early identification of dysphagia in hospitalized patients, particularly in those with high-risk comorbid conditions such as

older age, stroke, dehydration, malnutrition, neurodegenerative disease, pneumonia, cardiac disease, and the need for rehabilitation," they advised.

They also called for further research "to mitigate both the clinical and economic ill effects of this potentially devastating condition."

The authors reported no financial conflicts.

Primary source: Archives of Otolaryngology–Head & Neck Surgery

Source reference:

Altman K, et al "Consequences of dysphagia in the hospitalized patient: impact on prognosis and hospital resources" Arch Otolaryngol Head Neck Surg 2010; 136: 784-789.

© 2004-2010 MedPage Today, LLC. All Rights Reserved.

08/20/2010 04:07 PM
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Early Care Urged for Patients With Trouble Swallowing

'Dysphagia' significantly impacts hospital resources and patient outcomes, researchers say

URL of this page: fullstory_102287.html (*this news item will not be available after 11/15/2010)

By Robert Preidt

Tuesday, August 17, 2010

TUESDAY, Aug. 17 (HealthDay News) --

Difficulty swallowing (also called dysphagia) is associated with poor outcomes in hospital patients, researchers warn.

"The consequences of dysphagia can be profound.

Although it is appreciated that nutrition, hydration, quality-of-life issues and social isolation may arise, aspiration (especially if not immediately recognized) may be the pivotal factor that precipitates a significant decline in a patient's outcome," wrote Dr. Kenneth W. Altman, of the Mount Sinai School of Medicine in New York City, and colleagues.

An example of aspiration is when food gets into the airway.

In their study, the researchers analyzed data from nearly 272,000 dysphagia-related hospital admissions that were recorded in the 2005-2006 National Hospital Discharge Survey.

"Dysphagia was most commonly associated with fluid or electrolyte disorder, esophageal disease, stroke, aspiration pneumonia, urinary tract infection and congestive heart failure," the researchers wrote.

The investigators also found that being over 75 years of age was linked to a doubled risk of dysphagia.

The median number of days spent in the hospital was 40 percent longer for patients with dysphagia than for other patients -- 4.04 days versus 2.4 days.

Among patients undergoing rehabilitation, the risk of death was 13 times higher for those with dysphagia, which also increased the risk of death among patients with intervertebral disk disorders and heart disease.

"While dysphagia occurs in only a small portion of hospitalized patients, the impact on hospital resources is substantial," the researchers concluded.

"We recommend early identification of dysphagia in hospitalized patients, particularly in those with high-risk [coexisting] conditions such as older age, stroke, dehydration, malnutrition, neurodegenerative disease, pneumonia, cardiac disease and the need for rehabilitation.

The plan of care in these patients should include proper assessment, early intervention using appropriate therapy and aspiration precautions, and consideration of [alternate] feeding or supplementation options in the high-risk populations."

The study findings are published in the August issue of the journal Archives of Otolaryngology -- Head & Neck Surgery.

SOURCE: JAMA/Archives journals, news release, Aug. 16, 2010


Copyright (c) 2010 HealthDay. All rights reserved. fullstory_102287.html

09/08/2010 11:54 PM
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FOSAMAX, BONIVA, & Actonel, Long-Term Use of Bone Drugs May Be Linked to Esophageal Cancer

5 years of meds such as Boniva, Fosamax almost doubles chances, but actual risk still low, researchers say

URL of this page: fullstory_102905.html (*this news item will not be available after 12/02/2010)

Friday, September 3, 2010

THURSDAY, Sept. 2 (HealthDay News) --

People with osteoporosis who take drugs such as Boniva (ibandronate), Fosamax (alendronate) or Actonel (risedronate) to strengthen their bones may be at an increased risk of esophageal cancer, British researchers report.

This class of medicines, called oral bisphosphonates, are the most commonly used drugs to treat osteoporosis and other bone diseases.

While anecdotal reports have suggested that they may increase the risk of esophageal cancer, the scientific evidence has been limited, the researchers noted.

"What we lack at present is a full picture of the benefits versus risks for long-term use of bisphosphonates, which are increasingly commonly prescribed," said lead researcher Dr. Jane Green, a clinical epidemiologist, in the Oxford University's Cancer Epidemiology Unit.

"Our results are a small part of this picture."

There are no immediate implications for clinical practice, Green stressed.

"Esophageal cancer is uncommon, and even if risk is doubled it is still low" for any one person, she said.

Also, "like any observational study, we cannot be sure that the results reflect a true effect of the drugs -- it could be that people more likely to get cancer are prescribed bisphosphonates [more often] -- although we accounted for the major known possibilities.

As usual, more research is needed," Green said.

The report is published in the Sept. 2 online edition of the BMJ.

In the study, Green's team used the UK General Practice Research Database to collect data on almost 3,000 men and women with esophageal cancer, more than 2,000 with stomach cancer and over 10,000 with colorectal cancer diagnosed between 1995 and 2005.

They compared these patients with age- and sex-matched people without these conditions.

The team found people who had had 10 or more prescriptions for bisphosphonates written for them, or had received prescriptions for these drugs over about five years, had almost double the risk of esophageal cancer, compared with people who didn't take these drugs.

Green's group also found an increased risk for stomach or bowel cancer, according to the report.

Usually, esophageal cancer is seen in one of 1,000 people at ages 60-79 over five years.

Based on these findings, the researchers estimate that taking oral bisphosphonates over five years increases this to two cases per 1,000 people.

Another recent study that looked at the same link using the same database didn't find an increase in esophageal cancer from bisphosphonates, but this new study followed patients for twice as long as the earlier study and therefore had more "statistical power," the researchers said.

Diane Wysowski, an epidemiologist with the U.S. Food and Drug Administration and author of an accompanying journal editorial, commented that

"several adverse esophageal events have been reported with the use of oral bisphosphonates, including erosion and inflammation of the lining of the esophagus, esophageal stricture and perforation, and esophageal cancer."

If the results from this study are confirmed and oral bisphosphonates double the rate of esophageal cancer, esophageal cancer rates would still remain relatively low from a population standpoint, she said.

"However, because oral bisphosphonates are widely used on a chronic basis, the results, if confirmed, could have implications for a large number of patients," Wysowski said.

The possibility of adverse effects on the esophagus should prompt doctors who prescribe these drugs to consider risks vs. benefits, ask patients about digestive disorders before prescribing, and to reinforce directions for use on the basis of each individual product, she said.

Wysowski advises patients to: "Be sure to follow the directions for use and report to your doctor any difficulty swallowing or throat, chest, or digestive discomfort so that your doctor can evaluate the need for oral bisphosphonate discontinuation."


Jane Green, M.D., Ph.D., clinical epidemiologist, Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, England;

Diane Wysowski, Ph.D., epidemiologist, U.S. Food and Drug Administration;

Sept. 2, 2010, BMJ, online


Copyright (c) 2010 HealthDay. All rights reserved. fullstory_102905.html

10/18/2010 02:01 PM
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Possible Fracture Risk With Osteoporosis Drugs

The Food and Drug Administration (FDA) is warning there is a possible risk of a rare type of thigh bone (femoral) fracture in people who take drugs known as bisphosphonates to treat osteoporosis.

The agency warned patients and health care professionals of this risk on Oct. 13, 2010, because the rare type of femoral fracture has been predominantly reported in patients taking these prescription medications.

FDA says the possible risk of thigh fracture will be reflected in a labeling change for bisphosphonate medications that treat osteoporosis and in a medication guide that will be required to be given to patients when they pick up their prescription.

Bisphosphonates are a class of drugs that slow or inhibit the loss of bone mass.

They have been used successfully since 1995 to prevent and treat osteoporosis and similar diseases.

Osteoporosis is a disease in which the bones become weak and are more likely to break.

FDA says it is not clear whether bisphosphonates are the cause of the unusual bone breaks known as subtrochanteric femur fractures, which occur just below the hip joint, and diaphyseal femur fractures, which occur in the long part of the thigh.

Medication Guide, Labeling Change

The changes to labeling and the medication guide will affect only bisphosphonates approved for osteoporosis.

These include

oral bisphosphonates such as Actonel, Actonel with Calcium,




Fosamax Plus D, and

their generic products injectable bisphosphonates such as Boniva and Reclast and their generic products.

Labeling and the medication guides for bisphosphonates that are used for other conditions will not change.

FDA says the optimal duration of bisphosphonates treatment for osteoporosis is unknown—an uncertainty the agency is highlighting because these fractures may be related to use of bisphosphonates for longer than five years.

FDA medical officer Theresa Kehoe, M.D., says the agency continues to evaluate data about the safety and effectiveness of bisphosphonates when used long-term for osteoporosis treatment.

"In the interim, it's important for patients and health care professionals to have all the safety information available when determining the best course of treatment for osteoporosis,” she says.

Advice for Consumers

If you are currently taking bisphosphonates for osteoporosis, FDA advises that you

keep taking your medication unless you are told to stop by your health care professional read the medication guide.

It will describe the symptoms of an atypical femur fracture.

The guide also advises you to notify your health care professional if you develop symptoms tell your health care professional if you develop new hip or thigh pain (commonly described as dull or aching pain), or have any concerns with your medications report any side effects with your bisphosphonate medication to FDA's MedWatch program online: online.htm4

by regular mail: Use postage-paid, pre-addressed FDA form 35004, available online at

by Fax: (800) FDA-0178

by phone: (800) FDA-1088

FDA also recommends that health care professionals be aware of the possible risk in patients taking bisphosphonates and consider periodic reevaluation of the need for continued bisphosphonate therapy, particularly for patients who have been on bisphosphonates for longer than five years.

This article appears on FDA's Consumer Update page6, which features the latest on all FDA-regulated products.

Posted: October 13, 2010 ucm229127.htm

10/18/2010 02:04 PM
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Two-Thirds of Spinal Fractures Undiagnosed, Untreated:

Report Stooped back, loss of height and sudden back pain are all signals, experts warn

URL of this page: fullstory_104446.html (*this news item will not be available after 01/13/2011)

By Alan Mozes

Friday, October 15, 2010

FRIDAY, Oct. 15 (HealthDay News) -- As part of World Osteoporosis Day on Oct. 20, the International Osteoporosis Foundation has issued a new report on the serious but often overlooked problem of spinal fractures, declaring that two-thirds of them go undiagnosed and untreated.

A call to action, the report highlights the consequences of spinal fractures that are misdiagnosed as arthritis or mere back pain.

"These fractures must not be ignored," John A. Kanis, foundation president, warned in a news release.

"Their repercussions can be severe, resulting in stooped back, acute and chronic back pain, loss of height, immobility, depression, increased number of bed days, reduced pulmonary function and even premature death."

Even though spinal fractures are often linked to osteoporosis, experts at the foundation warn that physicians often fail to draw a connection between the two.

For example, just 40 percent of elderly women and less than 20 percent of elderly men who are diagnosed with a spinal fracture by X-ray are subsequently tested for osteoporosis, the report authors noted.

"Doctors must look out for evidence of spinal fractures, especially in their patients over 50 -- stooped back, loss of height, and sudden, severe back pain are the three tell-tale signs," Harry K. Genant, of the University of California, said in the news release.

"It is essential that doctors refer these patients for further testing and that radiology reports clearly identify spinal fractures as 'FRACTURED' to avoid ambiguity."

Genant co-authored the foundation report with Dr. Mary Bouxsein, of Harvard Medical School.

The pair pointed out that an undiagnosed and untreated spinal fracture raises the risk for more fractures and potential long-term disability.

In fact, they noted that 20 percent of women who suffer a spinal fracture will experience a second one within a year. Globally, a spinal fracture occurs every 22 seconds, the report stated.

SOURCE: International Osteoporosis Foundation, news release, Oct. 14, 2010.


Copyright (c) 2010 HealthDay. All rights reserved fullstory_104446.html


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