A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test. depending on physician instructions. Most oral medications also are withheld before the test. After the procedure. the nurse must monitor for constipation. which can occur as a result of the presence of barium in the gastrointestinal tract.