If you have been referred to us for a videofluoroscopic swallow study (VFSS), this information will help you prepare for the examination and give you some idea of what to expect when you attend.
What is a videofluoroscopic swallow study?
A videofluoroscopic swallow study is a moving x-ray examination of the mouth and throat.
Why do I need a VFSS?
You will have been identified by a speech and language therapist as possibly having swallowing difficulties. Some aspects of the swallow cannot be accurately checked without an x-ray. The x-ray will determine if there is a problem and if so what type of food and fluid are safest to eat, and whether there are any techniques to increase swallowing safety. You will need to give your permission for the procedure.
What happens during the VFSS?
The VFSS team consists of one or two speech and language therapists and a radiographer. The speech and language therapists will prepare the food and fluids, guide you through the assessment and interpret the findings. The radiographer will operate the x-ray machine and recording equipment, take the x-ray and discuss interpretation with the speech and language therapist.
Other professionals may be invited to the appointment if needed, for example a physiotherapist or local speech and language therapist. Family/carers are encouraged to be involved in the examination, because involvement and understanding is important in helping you to accept any changes to your diet that may be needed.
You can attend with one family member or carer, they will not be in the room during the x-ray but the findings of the assessment can be discussed with you and them afterwards.
The procedure will take approximately 30 minutes.
You may need to remove some clothing and wear a gown if the radiographer feels it is appropriate. Otherwise, a gown will be worn over the top of clothes just to protect your clothing from spills. Avoid wearing anything around the neck area which will impact the view of the x-ray, i.e. necklaces and earrings which will need to be removed.
You will be appropriately positioned standing or seated close to the x-ray machine. If you are a wheelchair user and it is not possible to remain seated in your own chair, help is available by a member of staff or a hoist to transfer you from your chair to the x-ray seat. Please let us know in advance if you will need help.
If you have a feeding tube in your nose or stomach it does not have to be removed.
You will be given small amounts of liquid, and different textured food as appropriate, coated in a paste that will show up on the x-ray. It tastes chalky but is not unpleasant. During eating and drinking, x-ray pictures will appear on a television monitor showing the swallow.
You will be able to rinse your mouth as soon as the examination is finished.
What are the risks?
We are all exposed to natural background radiation every day of our lives. Each x-ray examination gives us a small additional dose. This dose varies with each type of examination. Everything is done within the x-ray department to minimise this dose.
Are there people who are not suitable for VFSS?
If any of the following applies you should not undergo VFSS:
- If you are pregnant
- If you are medically unstable and fluctuating level of consciousness
- If you are unable to maintain an appropriate position
- If you have extreme distress or anxiety
- If you are known to have had an adverse reaction to barium before
- If you are nil-by-mouth for reasons other than swallowing problems.
Do I need any special preparation before the examination?
It is not necessary to go without food or fluids before the examination as it is not essential to have an empty stomach.
What if I cannot attend for my appointment?
Your appointment time will have been agreed with you beforehand, but if something happens and you cannot attend it is essential you contact the speech and language therapy department (see telephone numbers below) as soon as possible. You will then be offered another date and we will be able to reallocate valuable time to someone else.
You will be contacted before the appointment to check that you are still able to attend and to confirm that you are medically able to.
If you are unwell on the day of your appointment – please do not attend. Please contact the speech and language therapy team, as advised above, and your appointment will be rearranged when you are well.
What happens after the VFSS?
The results will be discussed in brief with you immediately after the x-ray. If you are at home the report will be sent to the local speech and language therapist and your GP within one week. The speech and language therapist will get in touch with you to discuss the results and implications in more detail if this is needed. A copy of the report can be sent to you if you would like this.
What if I have a percutaneous endoscopic gastrostomy (PEG)?
If you have a PEG, please let the therapist know when you arrive. Please bring equipment with you to flush your PEG following the assessment. You will need to flush the PEG 2-3 times during the two hours following the assessment using 50mls of water. If you have any concerns following the assessment about your PEG please contact the PEG team
I need an ambulance. Can you arrange this?
If you need an ambulance, you (or someone on your behalf) must contact North East Ambulance Patient Transport Service on 0191 2151515 to arrange one, giving them at least three working days’ notice. Please inform the department if you are arriving by ambulance.
What if I have any questions, suggestions or complaints?
Should you have any worries or concerns, please make these known to the person conducting the examination or by letter addressed to the hospital you are attending your appointment:
Further information
For any queries please contact your speech and language therapist.
Telephone Monday to Friday 9.00am to 4.00pm
Denton Park – 0191 2138841
RVI – 0191 2824324
Freeman – 0191 2138270
Freeman ENT including Head and Neck Cancer: 0191 2137635 (Option 3)
The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS. You can contact them on freephone 0800 0320202 or e-mail northoftynepals@nhct.nhs.uk
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS Choices website at www.nhs.uk.
