Videofluoroscopic Swallow Study (VFSS)

A videofluoroscopic swallow study (VFSS) is a moving x-ray examination of the mouth and throat.

Why do I need a VFSS?

Your speech and language therapist has assessed that you or your child might have having swallowing difficulties.

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.

What happens during the VFSS?

You will be cared for by one or two speech and language therapists and a radiographer.

The speech and language therapists will prepare the food and fluids, guide you or your child 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, e.g. 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.

The procedure will take approximately 30 minutes.

You or your child 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.

Make sure you don’t wear anything around the neck area which will impact the view of the x-ray. Necklaces and earrings which will need to be removed.

You or your child will be appropriately positioned standing or seated close to the x-ray machine. If you or your child 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 or your child has a feeding tube in your nose or stomach it does not have to be removed.

You or your child 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 or your child’s mouth 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?

You will not be suitable to have a VFSS if you are:

Pregnant
Medically unstable and fluctuating level of consciousness
Unable to maintain an appropriate position
Extreme distress or anxiety
Are known to have had an adverse reaction to barium before
Are nil-by-mouth for reasons other than swallowing problems.

Do I need any special preparation before the examination?

You do not need to go without food or fluids before the examination as it is not essential to have an empty stomach.

What happens after the VFSS?

We will discuss the results with you briefly immediately after the x-ray. Your report will be sent to your speech and language therapist and your GP.

Your speech and language therapist will get in touch with you to discuss the results and implications in more detail if this is needed. We can send a copy of the report to you.

What if I have a Percutaneous Endoscopic Gastrostomy (PEG)?

If you or your child have a PEG, please let the speech and language 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 2 hours following the assessment using 50mls of water. If you have any concerns following the assessment about your PEG please contact the PEG team.