What is a Video Fluroscopic Swallowing Exam (VFSE)?
A video flurorscopic swallowing exam (VFSE), also sometimes called a modified barium swallow exam (MBS) or "cookie swallow", is a radiologic examination of swallowing function that uses a special movie-type x-ray called fluoroscopy. The patient is observed swallowing a substance, such as barium, that can be seen on fluoroscopy to evaluate his or her ability to swallow safely and effectively. Patients are often observed swallowing various consistencies and textures, ranging from thin barium to barium-coated cookies.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
Fluoroscopy allows imaging of anatomical structures in real-time and allows the interpreting physician to observe structure and limited function.
A VFSE may be performed as an independent test, or together with an esophagram, which is also sometimes called a barium swallow exam. A swallow exam, which evaluates the uppermost portion of the GI tract, may be coupled with an esophagram, which evaluates the structure and function of the esophagus to the level of the stomach.
Upper GI Tract X-ray
Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum). Your physician will give you detailed instructions on how to prepare for your upper GI exam.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.
In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
On occasion, some patients are given an orally ingested iodinated contrast material, which is a clear liquid, instead of barium. For example, the alternative oral contrast could be used if a patient recently had surgery on their upper gastrointestinal tract.
Lower GI Tract X-ray
Lower gastrointestinal (GI) tract radiography, also called a lower GI or barium enema, is an x-ray examination of the large intestine, also known as the colon. This examination evaluates the right or ascending colon, the transverse colon, the left or descending colon, the sigmoid colon and the rectum. The appendix and portion of the distal small intestine may also be included. Your physician will give you detailed instructions on how to prepare for your lower GI exam.
The lower GI uses a special form of x-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast.
How should I prepare?
You should inform your physician of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.
Other than medications, you may be instructed to not eat or drink anything for several hours before your procedure.
You will also be asked to refrain from smoking or chewing gum prior to the exam.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental applicances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.
Hours of Operation
24 hrs./day, 7 days/week
Monday – Friday: 8:00 a.m. to 4:30 p.m.