A videofluoroscopic swallow study (VFSS) is a moving X-ray image that shows how the muscles in the mouth and throat work during swallowing. The procedure involves swallowing a white liquid called barium (mixed in with food and/or drinks) and then taking X-rays. A VFSS is also sometimes referred to as a modified barium swallow (MBS) or a cineswallow study.
Why do we conduct videofluoroscopic swallow studies?
A VFSS is recommended when there is concern about how well your child swallows, how well the airway is protected during swallowing and/or how well food moves from the mouth through the oesophagus (foodpipe). A VFSS may be considered if some of the following symptoms occur regularly:
- Frequent choking
- Coughing or gagging during meals
- Trouble handling saliva
- Gurgly breathing during or after meals
- Chronic respiratory problems including chest infections/ pneumonia
- Very fussy eating behaviours
- Difficulty swallowing
Please note: A VFSS or MBS is a different procedure to a barium meal, barium swallow or barium follow through.
How long will it take?
The procedure itself will take approximately 20 minutes, although some preparation time may be required.
Preparing your child for a VFSS
- Your child will need to fast (not allowed to eat or drink anything) for three hours before the VFSS. This ensures your child is hungry and wants to eat and drink during the procedure.
Please contact us before your appointment if your child is diabetic or you have concerns about fasting.
- If your child has special feeding equipment (e.g. spoons, cups, bottles or teats) please bring them along to use during the procedure.
- If your child has food allergies/intolerances or food preferences, please contact the Speech Pathology Department to discuss. Families are welcome to bring their own foods to the procedure.
- If your child has specialised seating / positioning equipment requirements, please contact the Speech Pathology Department to discuss.
- If your child has a local speech pathologist, he/she is welcome to attend the study. Please ask them to contact the Queensland Children’s Hospital Speech Pathology Department in advance, to discuss your child’s swallowing concerns.
- Please ensure your child does not wear clothing with metal clips or snaps.
- Please ensure all earrings and necklaces are removed prior to the study.
- Mothers / carers who are pregnant cannot be in the X-ray room during the procedure.
What happens during a VFSS?
- A small amount of barium (a chalky, white, radio-opaque liquid) is mixed with a variety of appropriate foods and drinks. The barium helps to outline the food and fluids more clearly on the X-ray picture.
- Your child will be seated in a special chair and will need to sit as still as possible throughout the procedure. You will be able to sit with your child during the procedure.
- Once your child is in position, the speech pathologist will ask you to feed your child a range of different food or drinks. If necessary, the speech pathologist or nurse may present the food or drinks. Afterwards, you will be able to see the X-ray pictures on a television screen.
What happens after the VFSS?
The speech pathologist will be able to discuss some preliminary results with you after the study. The procedure is also recorded so that it can be analysed in detail and shown to your child’s treating medical team if necessary. The speech pathologist and radiologist prepare a report describing your child’s swallowing function, and the results will help to guide appropriate therapy or medical intervention.
Are there any risks involved with this procedure?
The risks and complications with a VFSS can include, but are not limited to the following:
Common risks and complications
- Vomiting – requiring treatment with medication
- Constipation – drinking extra fluids and laxatives can help with this
- Diarrhoea, causing dehydration – drinking extra fluids can help with this
Less common risks and complications
- Pneumonia may occur if food/drink or fluid from the stomach goes into the lungs. This may require antibiotics and/or further treatment
Rare risks and complications
- An increased lifetime cancer risk due to exposure to radiation from X-rays.
- Allergic reaction to the contrast. This could result in a rash, hives, itching, nausea, fainting or shortness of breath. Medication may be given to relieve this.
- Death as a result of this procedure is very rare.
If you have any concerns or questions about the procedure, don’t hesitate to ask our staff.
Speech Pathology Department
Queensland Children’s Hospital
t: 07 3068 2375
Medical Imaging and Nuclear Medicine Department (1a)
Queensland Children’s Hospital
t: 07 3068 3066