Video Fluoroscopy v4

Videofluoroscopy 

Patient Information

What is a videofluoroscopy?

A videofluoroscopy is an x-ray examination of your swallowing.  It produces a moving image of the inside of your mouth and throat as you are eating and drinking which allows the Speech and Language Therapist to see exactly what is happening as you swallow and identify any difficulties you may be having.

Why do I need to have this procedure?

Your Speech and Language Therapist, who has already assessed you swallowing at your bedside, has recommended a referral for videofluoroscopy as a way of finding out exactly what happens when you swallow.  This is a more objective test which can look in more detail at the movement of your mouth and throat when you swallow and show whether food or drink is going down the wrong way.

The results of the videofluoroscopy will help the Speech and Language Therapist recommend the safest foods and drinks you can have and help identify treatment techniques. There is a possibility that the examination will show that it is not safe for you to eat and drink anything.

What do I need to do before the videofluoroscopy?

You can eat and drink as advised by your Speech and Language Therapist.  You do not need to fast.  Please take any medication as usual. 

Videofluoroscopy is non-invasive which means no scopes or tubes are passed into your body. 

You will not need to get undressed but may be asked to remove earrings and necklaces and occasionally glasses for the investigation.  A protective apron may be offered to protect your clothing from any spillages.

Where will I have to go?

Videofluoroscopy examinations are carried out in the X-ray Department of Royal Albert Edward Infirmary in Wigan or at Leigh Infirmary. Your appointment letter will tell you which hospital to go to.

How long will it take?

The investigation takes 10 to 15 minutes and the whole appointment usually takes about 30 minutes.

Who is going to be present? 

A Radiographer, two Speech and Language Therapists and possibly a Consultant Radiologist will be present during your appointment.  There may also be other doctors, therapists, nurses or students who may be observing the work of the videofluoroscopy clinic on that day. You are welcome to ask anyone what their role is and if you are unhappy to have observers, you are entitled to ask that they leave.

You can be escorted by a family member or a friend if you wish. They will be asked to wait in the waiting area for you during the procedure. If there is a reason you need their support for the procedure, this can be discussed with the Radiographer in clinic that day. 

What happens during the procedure?

Firstly, you will be helped to get into a seated position in the x-ray machine. If you are in a wheelchair, you may be able to stay in it or if you can, you may be asked to transfer into a static chair.

The Radiologist will ensure you are positioned correctly to get a good view of your head and neck on the x-ray.

One of the Speech and Language Therapists will then give you a variety of different textures and consistencies of food and drink to eat and swallow. These will be mixed with barium, a non-toxic powder to make it show up on the x-ray machine.  This may give things a bit of a   ‘chalky’ taste but otherwise it should not be unpleasant. 

The Speech and Language Therapist will tell you how s/he wants you to eat and swallow e.g. you may need to hold fluids in your mouth before swallowing. It is important that you listen carefully to these instructions

The other Speech and Language Therapist will be behind the protective screen. S/he will also be assisting in monitoring what is happening when you swallow. You may hear the Speech and Language Therapists discussing things with each other. You are entitled to ask questions about this discussion.

How will I get the results?

The Speech and Language Therapist may be able to give you recommendations straight away or s/he may have to take the images away to study in more depth. In this case, s/he will come and see you as soon as possible to discuss the findings and recommendations. You can ask questions at the end of the videofluoroscopy. We will send a report to your Consultant/ GP and we will write to you with a summary of the results. If required we will discuss the recommendations with you in a telephone or face to face follow up consultation.”  

The recorded images might be used for teaching purposes. Please state if you are not happy for your images to be used for this purpose. 

What happens next?

You can go back to your normal activities straight after the investigation, or as soon as you feel ready. The barium may make your bowel motion pale in colour for the following day or two. This is quite normal.

What are the benefits of a videofluoroscopy?

The benefit is that it allows us to directly observe what happens in your mouth and throat when you swallow. After this we will be able to advise you on the safety of your swallow and to plan your treatment. 

What are the risks of a videofluoroscopy?

During this examination there is a risk of a small amount of barium entering your airway. This could lead to chest infection. This risk is small and controlled.

There are some small risks involved with x-rays, but only the minimum amount of radiation is used to produce the images required. We all receive radiation naturally over our lifetimes. The radiation dose received from this examination is similar to the radiation we receive from the environment over 16 months.

What are the risks of not having a videofluoroscopy?

If this examination is not carried out, we won’t be able to fully investigate your swallowing problems. Your symptoms may persist, and we would not be able to give the best diet and fluid recommendations or treatment.  However you have the right to decline a videofluoroscopy examination.

Important information

Please tell us about any of the following:

• Allergies/ special dietary needs.
• If you are reliant on additional oxygen.
• If there is a possibility of you being pregnant the radiographers need to be informed.

• You can still have this examination if you wear a pacemaker.

Contact 

Speech and Language Therapy Department: 

Telephone Number:   01942 807 700

Email: wwl-tr.nutritionandspeechtherapy@nhs.net

Sources used for the information in this leaflet

Royal College of Speech and Language Therapists, “video fluoroscopic evaluation of oropharyngeal swallowing disorders (VFS) in adults: the role of Speech and Language Therapist, 2007

Watson, S.J., Jones, A.L., Oatway, W.B. & Hughes, J.S. (2005) Ionising Radiation Exposure of the UK Population: 2005 Review. Health Protection Agency RPD-001