Dysphagia Tests

Urgent safety information

If food has gotten stuck in your airway and you are having trouble breathing, call 911 for help right away.

Why this test may be ordered

• Persistent coughing or gagging when swallowing
• Feeling of food stuck in the throat
• Pain when swallowing
• Food or liquids coming back up through the throat or mouth
• Frequent heartburn, hoarse voice, weight loss, or drooling

Preparation and collection

You may need to fast (not eat or drink) for several hours before the test. Avoid smoking, chewing gum, or sucking on hard candy. Tell your provider about all medicines you take; do not stop any unless instructed. If you are having an upper endoscopy, arrange for someone to take you home due to sedation.

N/A

Bedside swallow: very low risk, but small chance of fluid entering the lungs. FEES and upper endoscopy: discomfort during insertion; rare serious complications include a tear in the intestine or bleeding (bleeding usually stops without treatment). VFSS (with barium): low radiation dose (not recommended if pregnant or think you may be pregnant); possible allergic reaction to barium; white stool for several days; constipation if barium does not pass completely.

Understanding results

Your results will show whether you have difficulty swallowing and what type of dysphagia may be present. Screening tests only indicate risk; confirmatory tests identify the specific area and cause.

• Screen-positive (higher likelihood of dysphagia): You may be at risk for a swallowing disorder that needs further evaluation. Limitation: This is a screening result only; it does not diagnose a specific type of dysphagia. Next step: Your provider will likely order follow-up confirmatory testing (e.g., FEES, VFSS, upper endoscopy).
• Screen-negative (lower likelihood of dysphagia): No immediate risk of dysphagia based on this screen. Limitation: This is a screening result only; it does not rule out all causes of dysphagia. If symptoms persist, discuss with your provider. Next step: If you continue to have symptoms, talk to your provider about further evaluation.
• Normal swallowing function: Your swallowing function appears normal. Limitation: Negative results do not guarantee that no swallowing problem exists; discuss with your provider if symptoms continue. Next step: Your provider will discuss the findings and may recommend additional monitoring or tests if symptoms persist.
• Abnormal swallowing function (type identified): You have a swallowing disorder affecting the mouth, throat, or esophagus. Limitation: Abnormal results may indicate a serious condition requiring further evaluation. The specific type (oral cavity, oropharyngeal, or esophageal dysphagia) will guide next steps. Next step: Your provider will explain the type and possible causes (e.g., stroke, neurologic disease, cancer, GERD) and may refer you to a specialist.

• Screening tests (e.g., bedside swallow, questionnaire) only indicate risk, not a confirmed diagnosis.
• Imaging and procedures carry small risks: fluid entry into lungs (bedside swallow), discomfort and rare complications such as tear or bleeding (FEES, upper endoscopy), low radiation exposure (VFSS), and possible allergic reaction or constipation from barium.
• Results must be interpreted by your healthcare provider along with your symptoms and medical history.

What to do next

For screening tests: if results show higher likelihood, your provider will likely order follow-up confirmatory testing (e.g., FEES, VFSS, upper endoscopy). For confirmatory tests: results will help identify the type and cause of dysphagia, and your provider may refer you to a specialist (speech-language pathologist, otolaryngologist, gastroenterologist, or neurologist) for further management.

• Do you cough or gag when swallowing?
• Do you feel food stuck in your throat?
• Do you have pain when swallowing?
• Have you had unexplained weight loss or drooling?

Evidence source

U.S. National Library of Medicine: Dysphagia Tests