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.
