The professionals at UW Health's Swallowing Clinic evaluate and treat adult and pediatric patients with concerns about their swallowing function. We perform comprehensive reviews, taking into consideration any medical, surgical, lifestyle, occupational and emotional factors related to your concern.
Treatment plans for swallowing problems are tailored to the patient based on the individual needs of the patient and family. Common treatment approaches include diet modifications, feeding strategies and swallow therapy. In some cases, medical or surgical interventions may also be indicated.
Vidoefluoroscopic Swallow Studies (VFSS)
During videofluoroscopic swallow studies (VFSS), also known as modified barium swallows (MBS), patients swallow barium while a video x-ray is used to visualize the swallow from the mouth to the top of the esophagus. Clinicians study the video in real time to identify swallowing difficulties.
Videofluoroscopy can be used to identify aspiration (food or liquid entering the airway) and residue. Speech pathologists may trial strategies during the evaluation to improve swallow safety or efficiency.
- Does the barium taste bad? Most people tolerate the barium without complaint. It has a slight apple flavoring.
- When do I get the results? The results are typically available immediately after completion of the evaluation. Speech pathologists review images with you in a private consultation room, explain findings and answer any questions.
- How long does the appointment take? The appointment typically lasts one hour.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
During fiberoptic endoscopic evaluation of swallowing (FEES), a small endoscope with a video camera is placed in the nose and down into the throat and records patients swallowing a variety of consistencies - typically milk, pudding and a cracker. The images are used to diagnose difficulty swallowing and help determine safest diet recommendations and appropriate treatment plan.
- Does it hurt? Most people tolerate the endoscope without complaint. It can be a little uncomfortable but it is not painful. A small amount of viscous lidocaine can be applied to the inside of the nose if a patient experiences discomfort.
- How long does the appointment last? The appointment typically lasts one hour.
- Can I eat before the appointment? You can eat and drink normally prior to the appointment. It is best not to come with a full stomach, as you will be required to swallow some food and drink for the test.
- How long does it take to get the results? Results are typically available immediately. The speech pathologist will review the images with you, explain the findings and answer any questions.
- Do I swallow the camera? You do not swallow the camera. The camera is attached to a scope that is inserted through your nose and into your pharynx (throat) but it is not swallowed.
High-resolution Pharyngeal Manometry (HRPM)
High-resolution Pharyngeal Manometry (HRPM) is sometimes added to videofluorscopic swallowing studies or fiberoptic endoscopic evaluations of swallowing to help get a more complete picture of the swallowing function. A manometer catheter is passed through the nose and throat and then swallowed into the esophagus. The catheter remains in place for several minutes while the patient swallows various volumes of saline (salt water). The manometer has 36 sensors that measure pressures in the throat and esophagus to help diagnose any weakness or obstruction contributing to difficulty swallowing.
- Does it hurt? Most patients tolerate passage of the manometer without complaint. It can be uncomfortable but not painful. Viscous lidocaine is typically used to numb the nasal passages and the throat to make the procedure more comfortable.
- How long does the appointment last? The procedure itself is very brief, typically lasting less than 10 minutes. The appointment varies in length from 30 to 90 minutes depending on any other additional testing that may be done in conjunction with manometry.