What is a video fluoroscopy swallow study?

Your doctor or speech & language therapist (SLT) will refer you for a video fluoroscopy swallow study (VFSS) in order to look at your swallowing difficulties in detail. We do not have this service locally so you will usually have to travel to London or Cambridge for this assessment.

Your SLT will have already completed an assessment of your swallow at home or clinic but this has not given them all the information they need.

A VFSS is a moving x-ray examination of swallowing. You will be asked to have different varieties of food and drinks and the images obtained will allow detailed analysis of your swallowing function at that point in time. Usually the SLT that has referred you will have given the team doing the VFSS information about your swallowing difficulty so they know which foods and drinks to offer you.

The VFSS allows your speech and language therapist to see how you are currently managing with chewing and swallowing, whether any food or drink gets stuck in your mouth or throat or if it goes down the wrong way (aspiration). We may then be able to recommend things you can do to improve swallowing; such, different positions to eat or drink in, or different types of food or drink that will make swallowing safer or easier.

Are there any risks? During the VFSS, there is a risk that some food or drink may go down the wrong way (aspiration). All care will be taken to minimise this risk and the amount that may potentially go down the wrong way. We will also take care to minimise the amount of x-ray radiation you are exposed to. The use of ‘contrast’ (a special liquid which shows up on x-ray) during the procedure is not usually associated with any problems but please let us know if you feel unwell during or after the examination.

How do I prepare for this examination? There is no preparation for this examination. Please bring any special cups or feeding utensils that you may use to help you with your eating and drinking. If there are any specific foods that you find difficult and would like to try, then you can bring these.

What happens during a VFSS? The team usually comprises of two specialist speech and language therapists and a radiographer. The assessment takes about 20 minutes. You will be asked to sit or stand by the x-ray machine. One part of the machine may move around by your head and neck when you swallow to achieve the best view. The speech and language therapist will ask you to take small amounts of drink and food as appropriate. The food or drink is mixed with “contrast” which shows up on x-ray. The speech and language therapist will assess the effectiveness and safety of your swallow. You may be asked to try a different position or strategy to make your swallow safer or more efficient. You should not experience any pain. Your swallow is recorded at different points throughout the assessment so that it can be reviewed later to help develop your treatment. You may not get feedback about how the study went straight away but the SLT will liaise with your local team and send a report so that we are able to help you with and strategies or recommendations made to improve the safety of your swallow.