Barium swallow - a useful investigation in otolaryngology? A systematic
literature review.
Abstract
Objectives: Barium studies are routinely requested to investigate a
range of conditions, however, its efficacy for several conditions is
unclear. Alongside findings from our audit in a district general
hospital, we aim to review current literature on the use of barium
swallow as an investigation for pharyngeal pouch, globus pharyngeus,
tertiary peristalsis and oesophageal malignancy in adults. Methods: A
systematic literature search was conducted on three databases for papers
published in English in the last ten years. Following screening, six
studies were included for pharyngeal pouch, five studies were included
for globus pharyngeus, seven studies were included for tertiary
peristalsis, and thirteen studies were included for oesophageal
malignancy. Results: Barium swallow is a useful and important
investigation in diagnosing pharyngeal pouch and can be useful to
investigate oesophageal dysmotility in tertiary peristalsis. Globus
pharyngeus patients do not clinically benefit from undergoing barium
swallow. Oesophagogastroduodenoscopy (OGD) should remain as first line
in diagnosing oesophageal malignancies. Conclusion: Barium swallow
should be used to investigate pharyngeal pouch and tertiary peristalsis,
but not used as the main investigation for globus pharyngeus or
oesophageal malignancy. There is a need to develop further guidelines
for investigations requested for dysphagia.