Abstract
The technique of double contrast barium meal examination is presented. This requires a liquid barium of low viscosity and high concentration. Transient gastric atony is required to prevent entry of barium into overlying small bowel, but this must not be too prolonged or the duodenal cap and loop will not be shown. Moderate duodenal relaxation gives views comparable to hypotonic duodenography, but it does preclude follow-through examination of the small bowel as the transit time becomes greatly prolonged. The surface pattern of the stomach showing areae gastricae can be routinely demonstrated, and thus becomes the criterion of an adequate examination. Small gastric carcinomas of the order of 2–3 cm can be demonstrated, benign and malignant disease can be distinguished and the surface changes in such conditions as chronic erosive gastritis and Menetriere's disease can be visualised as well as the small ‘ulcers' following endoscopic biopsies.
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