Timed barium esophagogram

The timed barium esophagogram (TBO) is a simple physiologic assessment and objective method for assessing the esophageal emptying used in patients with suspected achalasia and to evaluate and follow up patients who have been treated with myotomy or pneumatic dilatation^1,3.

Technique

Several techniques of TBO have been described in the literature with minor variations^1-6. After the overnight fasting before TBO, the primary method is similar to the usual barium swallow, and the entire study is performed in the erect posture using a standard radiography machine. Still, it includes taking several sequential images on the left posterior oblique position in 1, 2-3 (optional), and 5 minutes intervals after a swallow of (usually 100 to 250 mL) low density barium suspension (45% weight by volume) within 15-20 seconds.

The height and width of the barium column are measured on taken images to assess the esophageal emptying. Some authors have used the area of the barium column.