Swallowing Evaluation and Treatment
Evaluations
An individual experiencing one of more of the signs
described should see his or her physician.
Through the medical evaluation, which may include
a physicial examination of the structures and muscles
of the head and neck, the physician might suspect
that a swallowing disorder is present. Further
evaluation may be recommended, including referral
to a speech-language pathologist with expertise
in swallowing disorders
- Clinical Evaluation
The clinical evaluation includes a careful review
of the patient’s medical history, as well
as exam of the muscles and structures of the
mouth and throat. This may include administration
of food and liquid with observation of signs
and symptoms of swallowing difficulty during
the act of eating and drinking. Based
on the results of the clinical exam, the speech
pathologist may recommend a more objective evaluation
of swallowing and may advise performing a procedure
such as a modified barium swallow (also know
as a videofluoroscopic swallowing study or cookie
swallow ) or FEES (fiberoptic endoscopic evaluation
swallowing).
- Modified Barium Swallow Study (MBS)
A modified barium swallow study (MBS) is a radiologic
procedure that evaluates swallowing using a
device called a fluoroscope, which captures
pictures of swallowing in motion. During
this brief examination, the individual will
be asked to swallow a variety of liquids, semisolids
and solids, usually while standing or seated.
Swallowing function is analyzed and, if a problem
is detected, the test findings assist in treatment
planning.
- Fiberoptic Endoscopic Evaluation of
Swallowing (FEES)
During the fiberoptic swallowing evaluation,
a small flexible endoscope is passed through
the nose to assess swallowing. The structures
within the throat can be seen from a different
view, which offer additional information about
the swallowing process. This evaluation
also provides information that can be useful
in treatment planning should a problem be observed.
Swallowing Treatment or Therapy
In some cases, treatment of a swallowing disorder
requires direct medical or surgical intervention
by a physician. Therapy may also be recommended
to treat a swallowing disorder, depending on the
nature of the disorder. Therapy may include
physiotherapeutic exercise to strengthen the swallowing
musculature, modification of diet textures and
instruction in strategies and maneuvers to compensate
for the swallowing problem. Therapy is performed
by a licensed, certified speech pathologist with
special skills and knowledge in the area of swallowing
and swallowing disorders. The therapist
coordinates efforts with the physician, dentist,
nurse, dietician, occupational therapist, physical
therapist nutrition support specialist and any
others involved in the care of the person with
a swallowing disorder. The goal of treatment
is to return the individual to safe, effective
swallowing ensuring good health and optimal nutrition.
