New Test for Evaluation of Swallowing Available at FRMC

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Five Rivers Medical Center is proud to announce a new service for individuals with swallowing difficulties called Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Until now, individuals have had to drive to Walnut Ridge or Jonesboro for a swallowing evaluation.

What is FEES?

FEES is a comprehensive assessment of swallowing via use of an endoscope. The Speech Language Pathologist (SLP) uses a small, flexible tube with a camera and light on the end (an endoscope) to view your swallowing anatomy and function. The endoscope connects to a computer and video monitor. Your swallowing test is recorded so that it may be reviewed later. A printed report is generated from your test that will be provided to your doctor.

The comprehensive assessment includes five components:

  1. -Observation of the anatomy involved in the oropharyngeal (area where nasal passages connect to mouth/throat) stage of swallowing via endoscope.
  2. -Observation of the movement and sensation of critical structures within the hypopharynx (the area where the voice box and esophagus meet).
  3. -Observation of secretions.
  4. -Direct assessment of swallowing function with foods of different consistencies and liquid.
  5. -Response to therapeutic maneuvers and interventions to improve the swallow.

What is the FEES used for?

The purpose of the procedure is to evaluate your swallowing and may lead to

– recommendations regarding the adequacy of the swallow

– advisement on safe eating (ie: consistencies and use of thickeners)

– recommendations regarding appropriate interventions to facilitate safe and efficient swallowing

(In the process of this evaluation, if observations of swallowing structures or functions suggest the possibility of an undiagnosed medical condition, your referring physician will be notified. The referring physician determines if further medical evaluation is warranted).

Endoscopy may also be used in treatment as a therapeutic aid (e.g., to measure the effect of fatigue, to teach specific techniques, to educate patient/family) and to provide biofeedback to the individual with a swallowing disorder.

Why have the FEES?

When you have a swallowing test in the Speech Language Pathologist’s (SLP) office or in your hospital room, the SLP is unable to see what is happening inside your mouth and throat. The FEES test can help the SLP observe and evaluate :

  • -if food is going into your airway instead of your stomach, called aspiration
  • -what parts of your mouth and throat may not be working well
  • -what kinds of food are safest for you to swallow
  • -if certain positions or strategies help you swallow better 

What happens during the test?

You will be seated so that you are comfortable. A small tube will be gently inserted through your nose into your throat. You will be given some different things to eat and drink. They may be colored with food coloring so that they are easier to see on the monitor. The SLP and doctor can see a picture of your throat on the computer screen. 

What happens after the test?

The SLP will talk to you about the test and tell you and your family about the results. You may even watch a video so you can see the test yourself. The SLP will use the results to plan your treatment. You and your SLP will talk about what foods and drink are the safest for you and you may start swallowing therapy soon after your test.

Who should have the FEES?

Individuals that may develop problems with swallowing usually have progressive muscular or neurological diseases like Parkinson’s disease, which affects the muscles used in swallowing. Cancer of the throat and cancer treatments may also contribute to swallowing problems. Individuals who have had a stroke may have problems swallowing and can actually have the food enter into the lungs instead of the esophagus due to muscle weakness, which can lead to more medical complications like aspiration pneumonia. If you, or someone you know shows the following signs during eating : coughing/choking; increased phlegm or mucus noticed as a runny nose, throat clearing, gurgly voice; a feeling of something stuck in your throat; or pain/discomfort during swallowing ………… you would benefit from a swallowing evaluation and possible treatment of those symptoms. Five Rivers Speech Therapy Services also specializes in the treatment of swallowing dysfunction and use Vital-Stim to strengthen the muscles used for swallowing. Vital-stim is able to strengthen weakened swallowing muscles through electrical stimulation of the muscles. So you can not only use Five Rivers Medical Center for your diagnostic evaluation of swallowing, but also for treatment of the problem by our speech therapists at our out-patient facility. We are the only out-patient therapy clinic in Randolph County to provide comprehensive therapy services of physical, occupational, and speech therapies.

If you would like more information, or would like to set-up a swallowing or speech therapy evaluation, please call Five Rivers Medical Center Therapy Services at 870-892-6009— or stop by our clinic at 301 Country Club Road. “  Ashlyn Shipley SLP and Jennifer Daffron SLP would be more than happy to assist you with any Speech Therapy needs.



Article submitted by Holli Lillard PT

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