Dysphagia Tests
Reviewed
Also called: bedside swallow, clinical swallow, dysphagia screening tool, fiberoptic endoscopic evaluation of swallow (FEES), barium swallow, esophagram
Dysphagia tests are used to find out why you have trouble swallowing. Dysphagia is a term that means difficulty swallowing.
Specimen: N/A
Urgent safety information
If food has gotten stuck in your airway and you're having trouble breathing, call 911 for help right away.
Emergency numbers on this page are for the United States. Outside the US, call your local emergency number.
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
Your provider will let you know if there are any special instructions to follow. You may need to fast (not eat or drink) for several hours or more before your test. You may be asked to avoid doing anything that will coat your throat, such as smoking, chewing gum, or sucking on hard candy. You may need to stop taking certain medicines before the test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to. If you are having an upper endoscopy, you will be given a medicine that can make you drowsy, so you should arrange for someone to take you home.
There are several different types of dysphagia tests. A radiologist or a radiology technician most often does these tests. A bedside swallow test is a common type of dysphagia screening tool. The endoscope allows your provider to watch food travel down your throat as you swallow.
There is very little risk to having a bedside swallow, but there is a small chance that fluid might get into your lungs during the procedure. During a FEES or upper endoscopy, you may feel some discomfort when the endoscope is inserted, but serious complications are rare. You should not have a VFSS, which is a type of x-ray, if you are pregnant or think you may be pregnant. The radiation from these x-rays can be harmful to a developing baby. Tell your provider if you have any known allergies to the barium used in the test.
Understanding results
Your results may show your provider where the problem is or what type of dysphagia you might have.
- Screening shows you are at risk: A bedside swallow screen or other type of dysphagia screening tool will only show if you are at risk for one of the above disorders. Limitation: If your results show you are at risk, your provider will probably order follow-up testing. Next step: If you are having trouble swallowing, your provider may refer you to one of the following specialists.
- Oral cavity dysphagia: Oral cavity dysphagia, a disorder of the mouth in which you have difficulty chewing or breaking down food. Causes may include: Weakness after a stroke, Muscular or nerve problems. Limitation: They may also consider your symptoms and medical history to understand your test results. Next step: If you are having trouble swallowing, your provider may refer you to one of the following specialists.
- Oropharyngeal dysphagia: Oropharyngeal dysphagia, a disorder of the throat in which you have difficulty starting to swallow. Causes may include: Certain types of cancer, Neurologic diseases such as multiple sclerosis or Parkinson's disease, Pharyngoesophageal diverticulum, a small pouch that forms and collects food particles in your throat. Limitation: They may also consider your symptoms and medical history to understand your test results. Next step: If you are having trouble swallowing, your provider may refer you to one of the following specialists.
- Esophageal dysphagia: Esophageal dysphagia, a disorder of the esophagus in which you have difficulty moving food down your esophagus. Causes may include: Esophageal stricture (narrowing of your esophagus), Esophageal cancer, GERD (gastroesophageal reflux disease), a condition in which the contents of your stomach leak backward into your esophagus. Limitation: They may also consider your symptoms and medical history to understand your test results. Next step: If you are having trouble swallowing, your provider may refer you to one of the following specialists.
- 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
If you have questions about your results, talk to your provider. They may also consider your symptoms and medical history to understand your test results.
- What do my results show about where my swallowing problem is?
- Do I need any follow-up tests?
- Should I see a specialist?
- What can I do to swallow more safely?
Evidence source
Source: U.S. National Library of Medicine (MedlinePlus). Practices and reference ranges may differ in your country.