Barium will show the 'outline' of the interal portion of the lower GI tract (the lumen) and it will show if the lumen is thinner than normal or if it's pouched out. In other words, it will show whether there are strictures or pocketing. IIt will show larger or 'gross' abnormalities.
A barium study is not good for looking for 'small' abnormalities, or can it give the doc an idea of what might be going on on the surface of the lumen. So it depends on what your doc is looking for.
Barium is a great study if you have no complications like strictures or ulcers. I believe that pill camera is a better option for a first study.
Barium study hazards are toned down , but the truth is that they kill people sometimes because if even a drop of Barium gets into your bloodstream you can die. You would think that the medical science would be further along that this. Gastrografin is an otion if you are not allergic to iodine. Both Barium and gastrografin are irritants to the GI tract.
we have to do better...
Depends what they're trying to find. They can check for hiatel hernia, duodenitis, inflammation, celiac disease(partially), crohns disease. Basically the lower series can help identify major concerns which would lead to more tests like endoscopy and such.