Adult Videofluoroscopic Swallow Study

What is a Videofluoroscopic Swallow Study (VFSS)?
A Videofluoroscopic Swallow Study (VFSS), also known as a Modified Barium Swallow (MBS), is a procedure a speech pathologist completes in order to evaluate the anatomy and physiology of the oral cavity, pharynx, and screening of the esophagus. This is an x-ray study which allows the speech pathologist to evaluate the patient’s swallow.  It is performed when a patient has a known or suspected swallow dysfunction and allows the speech pathologist to make recommendations on diet, compensatory strategies, and/or treatment course. For information on pediatric VFSS click here.

How can I be seen for a swallow study?
1. To schedule an appointment a physician order is required 

                        -PM&R Speech Therapy swallow evaluation

                        -Videofluoroscopic Swallow Study

2. After verifying with your Primary Care Physician that the above orders have been written, contact UC Davis Health Physical Medicine and Rehabilitation department at (916) 734-7041 for an evaluation with a speech pathologist (clinical swallow study).

3. An outpatient clinical swallow study completed by a speech pathologist should be completed prior to scheduling a VIdeofluoroscopic Swallow Study (VFSS) to determine appropriateness of a VFSS.  Indications for the VFSS include but are not limited to: Oropharyngeal dysphagia, coughing, choking or drooling with swallowing, known or suspected aspiration (food going down ‘the wrong pipe’), neurological disorders likely to affect swallowing, pulmonary complications, recurrent pneumonia, unexplained weight loss, assessment of dietary textures or consistencies and assessment of protective maneuvers to limit or prevent aspiration.

4. After completing a clinical swallow study at our outpatient UC Davis Health Physical Medicine and Rehabilitation clinic at the Lawrence J. Ellison Ambulatory Care Center, if the speech pathologist determines you will require a VFSS she/he will assist with scheduling.

Where are swallow studies performed?

UC Davis Medical Center (main hospital)

2315 Stockton Blvd, Sacramento, CA 95817

First floor - Radiology Department 1775

The information desk may assist in directing you.

 
When are swallow studies performed?

Our VFSS are completed Monday, Tuesday, Thursday, and Friday between 1 p.m. and 3 p.m.

What:

The speech pathologist will meet you in the waiting room and take you to the designated radiology room. Depending on your mobility status, you will either sit in a special chair or stand next to the fluoroscopy (X-Ray) machine.  Family members will be asked to wait in the waiting room or watch from behind a window. The speech pathologist and radiology technician will wear lead vests.  The speech pathologist will give you food of varying textures and liquids mixed with a white substance called barium which allows them to view the food and liquid through x-ray.  General assessment includes all phases of swallowing from the preparatory oral phase through the oral transfer phase and pharyngeal phase.  The amount of food/liquid given and order of bolus presented is guided by patient’s performance, aspiration risk, abnormalities, and tolerance.  A screen of the esophagus may be completed dependent on patient’s symptoms and presentation to determine if the patient will require a Gastroenterologist/Ear Nose and Throat  referral.  The speech pathologist and radiologist, if needed, will review this video to make the most appropriate recommendations. The study only lasts a few minutes, but you should allow 30-60 minutes start to finish. Results may not be available to discuss with your speech pathologist on the day of the study, and your speech pathologist may call you to talk about the results or schedule you for follow-up in our outpatient clinic once the video has been reviewed.  Follow-up in our outpatient clinic may be recommended for further evaluation and treatment.

How do I prepare?

Please talk with your speech pathologist about any concerns or questions.

You should inform your doctor/speech pathologist if there are any allergies, especially to iodinated contrast materials. Also inform your doctor/speech pathologist about recent illnesses or other medical conditions.

Women should always inform their physician/speech pathologist and radiology technician if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

If you will be completing an Esophagram in conjunction with a VFSS your stomach must be empty of food. Therefore, your doctor will likely ask you not to eat or drink anything (including any medications taken by mouth, especially antacids) and to refrain from chewing gum after midnight on the day of the examination.  If you will only be completing a VFSS, a fast is not necessary but be aware you will be required to eat/drink.   

You may also be asked to remove jewelry, removable dental appliances, eye-glasses and any metal objects or clothing that might interfere with the x-ray images.

If there is a specific food/liquid you would like your speech pathologist to assess in particular, you can bring in food/liquid from home.