Gastrointestinal Radiology > Procedures > Barium Swallow > Modified (1)

The Modified Barium Swallow

  • The oropharyngeal and pharyngeal swallowing assessment, often known as a “modified barium swallow,” is a procedure that utilizes calibrated amounts of barium-coated “food”, in at least three consistencies, to assess the anatomy and physiology of the oral and pharyngeal phases of swallowing.

  • The examination is conducted jointly by a radiologist and a speech pathologist.

  • It is a fluoroscopic study which is recorded digitally or on videotape (videofluoroscopy), which permits replay of the examination in real time, as well as slow motion, and frame-by-frame analysis of oral and pharyngeal function and dysfunction. Simultaneous recording of sound permits documentation of the types and volumes of foods given to the patient and the presence or absence of a cough reflex in response to airway penetration or aspiration of ingested material.

  • Throughout the assessment, the fluoroscope should remain focused on the oral-pharyngeal-neck region and should not follow the bolus into the thoracic esophagus. Otherwise, aspiration after the swallow may be missed.

    NOTE: The procedure should terminated immediately if significant or life-threatening airway penetration or aspiration is demonstrated. As the physician member of the evaluation team, the radiologist is responsible for determining when it is appropriate to prematurely discontinue the examination.

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