Having a videofluoroscopy to assess your swallowing

What is a videofluoroscopy?

You have been referred to the speech and language therapy service because you have had some difficulties swallowing (dysphagia). You may have had surgery or treatment that has affected your swallowing. The speech and language therapists are trained to assess and treat swallowing problems. A videofluoroscopy examination enables us to try different foods and/or different techniques to help you swallow more effectively.

A videofluoroscopy is an X-ray that looks at your swallowing as it happens. The X-ray image is recorded as a moving image which allows your swallowing to be viewed in real time, slow motion or frame by frame.

This examination gives us a clear picture of what is happening in your mouth/throat when you swallow. It also allows us to see if there are any ways to make swallowing safer and easier for you.

What will it show?

The videofluoroscopy will show us:

• How you are managing food in your mouth, such as whether you can chew effectively and how your tongue moves.
• How well you manage to swallow food and drink.
• If anything gets stuck in your throat and if so where and what can be done to help you.
• If any food and drink go down the wrong way – into your lungs instead of your oesophagus (food pipe).
• The safest way you can manage your eating and drinking and ways in which we can help improve your swallowing.
• How to prepare for your videofluoroscopy
• If you are already eating or drinking at home, you can continue do so before your examination.
• If you are using an enteral feeding (tube) there is no need to stop this before the examination.
• It is important you take your medication as normal.
• Please remember, if you use dentures, bring them with you.
• Earrings, necklaces, and zipped tops may need to be removed before the examination. This is because they can interfere with the X-ray image.

What does the procedure involve?

The videofluoroscopy will be undertaken by two speech and language therapists and a radiographer. The speech and language therapists will assess your swallowing and chewing ability. They will also advise as to the best consistencies of food and drink to try and may explain ways in which you can make your swallowing easier. The radiographer will operate the X-ray equipment.

You will be seated in front of the X-ray machine. If you are a wheelchair user, this will be discussed with you prior to your appointment to ensure we can accommodate you in the X-ray suite.

You will be given a range of food and drink consistencies. These will have been mixed with barium so they will show up on X-ray when you eat and drink. Consistencies will be prepared according to your swallowing difficulties.

The team will explain what is happening throughout the procedure. Please do ask us any questions you may have.

One of the speech and language therapists may ask you to try various techniques to see if they help with your swallowing such as changing the position of your head. Once the X-ray is completed you may be able to view your swallowing on the X-ray screen.

The examination will take approximately 30 minutes in total.

What happens after the procedure?

If you are an in-patient, your speech and language therapist and/or medical team will discuss the results with you.

If you are and out-patient, you may require a further appointment with your speech and language therapist to discuss the results. A written report will be sent to the doctor who referred you and your GP. A copy of the report can also be sent to you if you wish.

Risks and side effects

Exposure to radiation

As with any X-ray, there is exposure to external radiation during this procedure, but this is only for a fraction of a second and the benefits of having the X-ray outweigh the small radiation risks.

To avoid any unnecessary risks, family members or carers are asked to stand behind the screen if they need to be present during the examination. Young babies and children are not permitted in the X-ray suite.

If you are pregnant or think you may be pregnant it is extremely important that you advise the speech and language therapist or the radiographer before the examination. This is because radiation, even in small doses, can harm your unborn baby.

Aspiration

This is when food or drink goes down the wrong way, into your windpipe and your lungs. This can happen during the examination and may be the reason you have been referred for a videofluoroscopy.

We take strict precautions to avoid this and take immediate action should it occur.