What is a Fiberoptic Endoscopic Evaluation of Swallowing?
A fiberoptic endoscopic evaluation of swallowing (FEES) is a test used to evaluate your swallowing function. A speech pathologist looks into your throat using an endoscope (a small flexible tube with a light attached) while you eat and drink.

Why is it ordered? What information will it give my doctors? How will it help me?
The FEES will test your ability to swallow food and drink safely and comfortably. If you have trouble, called dysphagia, you may be at risk for aspiration. Aspiration occurs when food or drink enters the windpipe, potentially going into the lungs. Aspiration may put you at risk for developing an infection of the lungs, called aspiration pneumonia. Swallowing problems may also put you at risk for not getting enough liquids or food (dehydration or malnutrition).

Based on information from the study, the speech pathologist will help your doctor determine the best way for you to get the nutrition that you need. This may include changing your diet, using strategies to make swallowing safer and easier, or other options.

What should my doctor know before I have this procedure done?
Your doctor should know if you have had any surgery to your neck, throat, or nose. You should also let your doctor know if you have a history of frequent nosebleeds.

Where will this be done?
The study can be done in your hospital room, if you are an inpatient, or in an examination room in the outpatient clinic.

Do I need someone to drive me home afterward?
No.

Do I need to do anything to get ready for this test?
No.

What happens during the procedure?
You will be sitting up in your hospital bed or chair. The speech pathologist will pass the endoscope through your nose and into the upper part of your throat. Your vocal cords and the top of your windpipe will be seen on a monitor. You will be given food and drink to swallow during the test, and the speech pathologist will be able to see whether any material enters your windpipe. If you have swallowing problems, you may be asked to try different techniques or positions while you swallow to see if they help. The food and drink used for the study are dyed green with food coloring to make them easier to see on the monitor.

Is this procedure painful?
Some people experience mild discomfort during the procedure, which may include a feeling of pressure or tightness in the nose or a gagging sensation.

How long does it take?
The study usually takes about 10 to 15 minutes. Then the speech pathologist will review the results and discuss them with you.

What are the risks with this procedure?
If you have swallowing problems, there is a risk that you may aspirate a small amount of food or drink during the procedure. The speech pathologist will make every effort to minimize any aspiration that occurs. There is less than 1 percent chance that you may experience a mild nosebleed or laryngospasm, which is a sudden brief closure of the windpipe.

How will I get the results of this test?
The speech pathologist will discuss the results and determine the best nutrition plan with you and/or your doctor. A full report of the study will be given to your doctor.

This article is intended as a resource for patients receiving their cancer care at Duke University Hospital or Duke Clinic. It is not intended to substitute for medical advice from your healthcare team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.