Fiberoptic Endoscopic Evaluation of Swallowing

In order to determine what is causing your swallowing problems, your doctor may order a fiberoptic endoscopic evaluation of swallowing, known as FEES. This test allows your doctor to identify what part of the swallowing process is causing your swallowing disorder.

In addition to determining what part of your throat is not working correctly, it can also help determine if there are certain foods or liquids you should avoid or even certain positions that could help you swallow more safely.

The Swallowing Process

There are four stages that make up the swallowing process:

  • Stage 3: Pharyngeal stage. Food or liquid passes through the pharynx and larynx into the esophagus.

The FEES Process

A fiberoptic endoscopic evaluation of swallowing involves the use of a thin, flexible tube called an endoscope. The instrument has a light and tiny camera to capture as much information about how you swallow as possible.

An anesthetic will be sprayed in your nose and throat to numb these areas before the procedure to make you more comfortable. The endoscope is then passed through your nose and down into your pharynx. The endoscope will be moved further moved down to get a better look at your vocal folds. The endoscope allows your doctor to see your pharynx, larynx and trachea on a video screen.

There are two steps to the FEES test.

The first phase allows your doctor to see how you swallow saliva before the introduction of food. This involves looking at the structure of your pharynx and larynx.

The second phase involves food. Food and liquid of different textures and sizes will be ingested and monitored. Your doctor may even use food color to dye the food and liquid so it is easier to see onscreen.

The procedure typically only takes 20 minutes.

FEES Risks

Like any medical procedure, there are risks. The most common ones for FEES include:

  • Nosebleed
  • Discomfort
  • Gagging or vomiting
  • Aspiration

What Happens After FEES?

Most are able to drive themselves home and resume normal activity after the procedure.

If the FEES determines what is causing your swallowing issues, your doctor will come up with a treatment plan. This typically involves modifying the types of food you eat or make changes in your positioning while eating. You may also need to learn new methods for swallowing better.


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