Modified Barium Swallow

Cookie swallow or videofluoroscopy.

To evaluate the swallowing process for people who are having problems speaking or swallowing food without aspirating it into the windpipe (a variation of the upper gastrointestinal (series).

By using a swallowed contrast material which can be seen using X-rays, the physician is able to see all structures involved in swallowing (from the oral cavity to the esophagus) on a video screen while the test is taking place.

• You will be asked to refrain from eating or drinking for several hours before the test.
• You undress and don a hospital gown.
• The radiologist or technician will strap you to a table that tilts vertically.
• The fluoroscopic tube, attached to a video monitor, will then be placed to give the examiners the desired view.

• You will be given small amounts of a barium preparation of varying consistencies from thin liquids to paste to a piece of coated cookie.
• Varying the amounts and consistency of the contrast material allows your doctor to determine which types of food are difficult for you to swallow and to locate the structure responsible for the trouble. The fluoroscopic screen allows the physician to view the results as the test takes place.
• The test is usually performed with a speech pathologist present who can assess your swallowing ability and devise a strategy to correct the problem. You may be asked to change your head position, breathing pattern, chewing habits, or the consistency of your food.

You are free to leave and resume normal activities.

Inability to remain still while the test is performed.

The otolaryngologist/radiologist and speech pathologist look directly at a video monitor to see a magnified view of swallowing structures. If possible, they will continue the test with modifications until the abnormality is detected and resolved.

• It allows both diagnosis and treatment in some cases.
• It provides a direct view of structures.
• It's relatively painless.
• It's inexpensive.

• It provides a low level of detail for examining structural damage.
• You must swallow the contrast material, which some people are unable to tolerate.
• You must remain very still during the test.
• The stage of swallowing involving the esophagus is not adequately studied using this method.

• If the speech pathologist is able to recommend strategies during the test to resolve the problem, no further testing or treatment is needed.
• If test results are not definitive, endoscopy may be recommended.