How to Evaluate Your Swallowing Problems

Evaluation of the swallow includes a thorough head and neck exam including a neurologic exam as well as a functional exam of the swallow. “Functional” means watching the throat while swallowing is occurring. The functional exam can be done from the side while using x-rays (otherwise known as “radiographs or fluoroscopy), which is also called a barium swallow. Sometimes a speech therapist is present for that exam to evaluate the swallow using different techniques (modified barium swallow).

The other way is called functional endoscopic evaluation of swallowing (FEES) or with sensory testing (FEESST). This is a test where a small camera in a tube (3 mm in diameter) is inserted through the nose to the back of the throat and the examiner, either a speech pathologist or a physician, records the action of the throat while the patient is swallowing food or liquid. The benefit of this testing method is that the inside view is real-time and no radiation is used to obtain the picture. The nose is anesthetized during this procedure so there is no pain and it only takes a few minutes. In addition, the result of compensatory strategies or maneuvers cn be tested during this procedure to optimize the patients swallow.