Table 1

Benefits and drawbacks of using barium and water-soluble contrast

BariumWater-soluble
Benefits
  • Better definition for subtle findings

  • No risk of pneumonitis when performing swallow studies8

  • Hyperosmolar properties contribute to reducing intestinal wall edema in small bowel obstruction, reducing length of stay for those patients who don’t require surgery9

Drawbacks
  • Barium peritonitis

  • Barium impaction (can become inspissated since not water-soluble)10

  • Risk of pneumonitis if aspirated11