What test is generally performed to diagnose a stricture after gastric bypass surgery?

The most appropriate test for diagnosing a stricture after gastric bypass surgery is an upper GI barium swallow. This imaging test is particularly useful because it allows for the evaluation of the upper gastrointestinal tract and can help identify any narrowing (stricture) in the anastomosis created during the surgical procedure.

During a barium swallow, the patient ingests a barium solution, and X-rays are taken of the esophagus, stomach, and proximal small intestine. This allows the physician to visualize the passage of the barium through the gastrointestinal tract, helping to assess any obstruction or stricture that may be affecting the flow of food and liquids.

Other diagnostic methods mentioned serve different purposes. Colonoscopy, for instance, is focused on the lower gastrointestinal tract and thus would not be useful in assessing issues post-gastric bypass. Laparoscopy, being an invasive surgical procedure, is typically used for direct visualization and intervention rather than initial diagnosis. Endoscopy (EGD) is also a possible option for evaluating the upper GI tract, but it’s less commonly used as the first-line diagnostic tool for strictures following gastric bypass compared to the barium swallow, which is non-invasive and provides clear imaging of the issue at hand.