Fibreoptic Endoscopic Evaluation of Swallow (FEES) Clinic
Fibreoptic Endoscopic Evaluation of Swallow (FEES) Clinic
Patient Information
Community Speech and Language Therapy Department
- Author ID: EG
- Leaflet Ref: CM 319
- Version: 1
- Leaflet title: Fibreoptic Endoscopic Evaluation of Swallow (FEES) Clinic
- Date Produced: June 2024
- Expiry Date: June 2026
What is FEES?
Fibreoptic endoscopic evaluation of swallowing (FEES) is a detailed swallowing assessment using a camera called an endoscope to assess your swallow in more detail. The endoscope allows the speech and language therapist to see inside your throat. The endoscope is flexible and connects to a computer and video monitor or screen.
Why do I need to have this Procedure?
Your Speech and Language Therapist, who has already assessed you swallowing, has recommended a referral for FEES 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 throat when you swallow and show whether food, drink or saliva is going down the wrong way, this is called ‘aspiration.’ The FEES allows us to use different techniques/food that might help you swallow more effectively. FEES may be used to check on your swallow after a period of rehabilitation.
What do I need to do before the FEES?
You can eat and drink as advised by your Speech and Language Therapist. Please take any medication as usual. You should let your Speech and Language Therapist know if you are prone to nose bleeds that do not stop, sometimes called epistaxis, also if you have had nasal surgery or if you have Creutzfeldt-Jakob Disease (CJD), as you may require a different type of swallow assessment.
Where will I have to go?
FEES assessments are carried out in the Ear, Nose and Throat suite at the Thomas Linacre Centre. Your appointment letter will give you the exact details of your appointment.
Who is going to be present?
Two or three Speech and Language Therapists will be present during your appointment. There may also be other doctors, therapists, nurses, or students who may be observing the work of the FEES 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.
What happens during the procedure?
You will be given a consent form prior to the procedure. When you are called into the room, you will be asked to sit upright in a chair. The monitor will be behind you; it shows the images from the endoscope.
A small flexible endoscope (camera) will be placed into one nostril and moved through your nose until a clear view of your throat is obtained. You will be asked to do several things, for example say certain sounds, swallow your saliva, eat and drink (if appropriate), with the camera looking at your throat. Food and drink may be dyed to enable a clearer view of it during the swallow. The test normally takes around 10-15 minutes; however, the whole appointment may take around 30 minutes.
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, you will be contacted with the results as soon as possible. You can ask questions at the end of the FEES. We will send a report to your Consultant/GP and we will write to you with a summary of the results.
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.
What are the benefits of a FEES?
The benefit is that it allows us to directly observe what happens in your 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 FEES?
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.
What are the risks of not having a FEES?
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 FEES examination.
Important information
Please tell us about any of the following:
• Allergies/ special dietary needs.
• If you are reliant on additional oxygen.
If you have any questions about the clinic or the procedure, contact:
Telephone Number: 0300 7077700
Email: wwl-tr.nutritionandspeechtherapy@nhs.net
Sources used for the information in this leaflet:
Wallace S, McLaughlin C, Clayton J, Coffey M, Ellis J, Haag R, Howard A, Marks H, Zorko R. Fibreoptic Endoscopic evaluation of Swallowing (FEES): The role of speech and language therapy. London: Royal College of Speech and Language Therapists, Position paper. 2020