What is fiberoptic endoscopic evaluation of swallowing?

Fiberoptic endoscopic evaluation of swallowing (FEES) is a test used to evaluate your swallowing function. A speech-language pathologist passes a flexible endoscope (a small camera with a light) through your nose to look at your throat while you eat and drink.

What happens during the procedure?

The speech-language pathologist will use a lubricant on an endoscope to pass it through your nose and into the upper part of your throat smoothly and quickly while you are awake and seated upright. Parts of your throat (larynx), including your true vocal cords, and the top of your airway (trachea) will be displayed on a video screen.

You will be given food and drink that has been dyed a bright color -- usually green -- to swallow during the test. The bright color allows the speech-language pathologist to easily see how and where the food travels through your throat. The speech-language pathologist will evaluate how safely and easily the food and liquid travels through your throat and enters into the top part of your stomach.

If you have swallowing problems, you may be asked to try different techniques or positions while you swallow to see if they help.

FEES also provides a detailed picture of your throat so it can be a helpful in evaluating the source of pain, hoarseness, or other problems relating to the throat.

What information will FEES give my speech-language pathologist and doctor?

FEES will test your ability to swallow food and drink safely and comfortably. Based on information from the FEES, the speech-language pathologist will help your doctor determine the best way for you to get the nutrition you need. This may include a modified diet, strategies to make swallowing safer and easier, or other options.

Is the procedure painful?

No. Some people experience mild discomfort during the procedure, which may include a feeling of pressure or tightness in the nose or a gagging sensation.

All of the speech-language pathologists at the Duke Swallow Center have experienced fiberoptic endoscopic evaluation of swallowing firsthand.

How long does it take?

The study usually takes 10 to 15 minutes. Afterward, the speech-language pathologist will review the results and discuss them with you. Most times, the study is video-recorded so you can watch and learn about the results immediately after the test.

What are the risks involved?

There is less than 1 percent chance that you may experience a mild nosebleed or laryngospasm, which is a sudden brief closure of the airway.

If you have swallowing problems, there is a risk that you may aspirate a small amount. The speech-language pathologist will make every effort to minimize any aspiration that occurs.

What should my speech-language pathologist know before I have this procedure done?

Your speech-language pathologist should know if you have had any surgery to your neck, throat, or nose. You should also let your speech-language pathologist know if you have a history of frequent nosebleeds, are on a blood thinner, or have allergies to foods or food dyes.

Where will this be done?

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

Can I drive home afterward?

Yes.

Do I need to prepare for this test?

No.

How will I get the results of this test?

The results of your test will be discussed with you immediately after the test. Additionally, a full report of the test will be given to your doctor. The speech pathologist will work with you and your doctor to determine the best nutrition plan for you based on the results.