If you have been referred for a fibreoptic endoscopic evaluation of swallow study (FEES), this information will help you prepare for the examination and give you some idea of what to expect when you attend.
What is a FEES assessment?
A FEES assessment is a detailed assessment of an individual’s swallow using a camera called an endoscope. The camera is long, thin and flexible and will be passed through the nose so that a clear view of the throat can be seen. It allows the speech and language therapist to look at the throat muscles and how the swallow is working, to make the swallow as safe and effective as possible.
The procedure is extremely safe and has a low risk of complications or side effects. You may experience some discomfort when the camera is being passed through the nose, but this usually stops as the camera is fully positioned in the throat.
Why do I need a FEES?
FEES will benefit anyone who feels that their swallow is unsafe or ineffective. This is usually anyone with eating, drinking and swallowing difficulties, also known as dysphagia. You will have been identified by your speech and language therapist as possibly having swallowing difficulties. Some aspects of the swallow cannot be accurately checked without using the endoscope.
FEES can help the therapist find out:
- If food or saliva is going into your airway instead of your stomach, called aspiration.
- What parts of your mouth and throat may not be working well.
- What kinds of food are safest for you to swallow.
- If certain positions or strategies help you swallow better.
What happens during the FEES?
A FEES assessment will take approximately 5-10 minutes. The FEES team consists of two people; one or two speech and language therapists and/or a speech and language therapy assistant. The team will prepare the food and fluids, guide you through the assessment and interpret the findings.
You will be appropriately positioned in a seated position close to the endoscopy machine. If you are a wheelchair user, we can position you next to the equipment in your own chair.
The assessment involves one member of the team passing a small flexible camera through the nose so it sits in the throat. Once the therapists are able to see inside the throat, you will be given small amounts of liquid, and different textured food as appropriate. The food and drink is usually coloured blue with food colouring, to allow it to show up on the camera. This does not affect the taste of the food or drink.
If you have special dietary requirement or if you are struggling with a particular type of food, it can be helpful to bring food to your assessment to ensure a more comprehensive investigation.
The images from the assessment will be recorded so that the speech and language therapist can interpret the findings. The images can also be played back to you, if appropriate. From the assessment, the speech and language therapist will be able to help manage your swallow problem and plan further rehabilitation, as required. Out-patients can go home immediately after the appointment as there are no after-effects.
Other professionals may be invited to the appointment if needed.
You can attend with one family member or carer, they can be in the room during the assessment. The findings of the assessment can be discussed with you and them afterwards.
You will not need to remove any clothing, but an apron may be placed over your clothing to protect you from spills.
If you have a feeding tube in your nose or stomach it does not have to be removed, please let the therapist know prior to the assessment.
What are the risks?
FEES is a safe test with very few problems reported, however if you have a history of nose bleeds or fainting please let your therapist know prior to the exam. FEES can cause mild to moderate discomfort as the scope is inserted but once it is in position this feeling normally improves. Anaesthetic cannot be used as it may numb the throat and affect the swallow.
Are there people who are not suitable for FEES?
- If any of the following applies you should not undergo FEES:
- 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 passing an endoscope before.
- If you are nil-by-mouth for reasons other than swallowing problems.
Do I need any special preparation before the examination?
There is no preparation necessary for this test. If you are eating and drinking then you may continue to do so right up until the FEES is carried out.
What happens after the FEES?
The results will be discussed in brief with you immediately after the assessment. If you are at home the report will be sent to your GP and any other relevant services 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.
Contact
Contact telephone number: 0191 2137635 (Option 3)
