What Is a FEES Swallow Study—and Why Would I Need One?

Coughing when you drink water. Feeling like food is getting stuck. Avoiding certain foods because they’re becoming harder to swallow. A voice that sounds wet or different after eating.

Swallowing problems can show up in many ways—and sometimes, they aren’t obvious at all.

If you or someone you love is having difficulty swallowing, a Speech-Language Pathologist (SLP) may recommend an instrumental swallowing assessment to better understand what’s happening.

One option is called FEES, or Fiberoptic Endoscopic Evaluation of Swallowing.

At Marigold Speech & Co. in Janesville, Wisconsin, our trained SLP FEES Endoscopists provide outpatient FEES swallow studies for adults experiencing swallowing concerns.

What Is FEES?

FEES stands for Fiberoptic Endoscopic Evaluation of Swallowing.

It is an instrumental swallowing study that allows a specially trained clinician to directly view structures in the throat and evaluate swallowing function.

During the assessment, a small, flexible scope is gently passed through the nose. The camera provides a detailed view of the throat while the patient eats and drinks different foods and liquids as clinically appropriate.

This allows the clinician to gather information that simply cannot be obtained by watching someone eat from the outside.

There is no radiation involved in a FEES swallow study.

Why Would Someone Need a Swallow Study?

Swallowing is something most of us don’t think about—until it becomes difficult.

Difficulty swallowing is called dysphagia, and it can occur for many different reasons.

A swallowing evaluation may be recommended when someone experiences symptoms such as:

* Coughing or choking while eating or drinking

* Frequent throat clearing during or after meals

* Feeling like food or pills are getting stuck

* Difficulty swallowing certain foods or liquids

* A wet or gurgly-sounding voice after swallowing

* Taking significantly longer to finish meals

* Avoiding foods that have become difficult to eat

* Unexplained changes in eating or drinking

* Difficulty managing saliva

* Concerns about swallowing following an illness, hospitalization, surgery, or neurological event

Sometimes swallowing difficulties are noticeable.

Other times, a person may not realize there is a problem.

That’s one reason an instrumental swallowing assessment can be so valuable.

What Can a FEES Swallow Study Tell Us?

A clinical or bedside swallowing evaluation provides important information, but there are limits to what can be determined without actually viewing the swallowing process.

FEES allows a trained clinician to gather objective information about swallowing function and determine whether additional recommendations or treatment may be appropriate.

Rather than guessing based only on symptoms, an instrumental assessment provides a closer look at what is occurring during swallowing.

This can help guide individualized recommendations based on the person’s actual swallowing function.

What Happens During a FEES?

One benefit of FEES is that the assessment can be completed in an outpatient clinical setting.

A thin, flexible scope is passed through the nose and positioned so the clinician can view the throat. The patient is then given selected foods and liquids while the clinician evaluates swallowing.

The assessment is individualized. Foods, liquids, and strategies used during the study may vary depending on the person’s symptoms, medical history, current diet, and clinical needs.

You remain awake and participate throughout the assessment.

Most importantly, the purpose isn’t simply to determine whether you “pass” or “fail” a swallow study.

The goal is to understand your swallowing and determine what may help you eat and drink as safely and comfortably as possible.

Does FEES Use Radiation?

No.

FEES does not use radiation.

This is one of the features that makes FEES a valuable option for instrumental swallowing assessment.

Because there is no radiation exposure, the clinician can observe swallowing across foods and liquids as clinically appropriate without radiation being a limiting factor.

FEES vs. a Modified Barium Swallow Study

Patients sometimes ask whether FEES is the same thing as a Modified Barium Swallow Study.

They are different instrumental swallowing assessments.

A Modified Barium Swallow Study (MBSS) uses X-ray imaging and barium to evaluate swallowing.

FEES uses a small flexible camera passed through the nose to view the throat during eating and drinking and does not involve radiation.

Both assessments can provide valuable information. One is not automatically “better” than the other. The most appropriate assessment depends on the individual, their symptoms, medical history, and the specific information needed.

A qualified healthcare professional can help determine which type of swallowing assessment is appropriate.

Who Might Benefit From FEES?

Swallowing difficulties can occur across adulthood and aren’t limited to one diagnosis or age group.

A FEES swallow study may be considered for individuals experiencing new or ongoing swallowing concerns associated with neurological conditions, stroke, head and neck cancer, surgery, hospitalization, progressive conditions, changes related to overall health, or other medical circumstances.

You also don’t need to wait until swallowing becomes severely difficult to ask questions.

New or persistent changes in swallowing deserve attention.

Swallowing Problems Aren’t “Just Part of Getting Older”

Swallowing can change throughout life, but persistent coughing, choking, difficulty managing food, or other significant swallowing symptoms shouldn’t automatically be dismissed as normal aging.

Dysphagia can affect more than whether someone can finish a meal.

It can affect hydration, nutrition, medication management, social participation, independence, and overall quality of life.

If something about eating or drinking has changed, it’s worth discussing with a healthcare professional.

What Happens After a FEES Swallow Study?

The next step depends entirely on what the assessment shows.

Some individuals may benefit from swallowing therapy. Others may need specific recommendations, additional medical evaluation, or collaboration with other healthcare professionals.

The important part is that recommendations can be based on objective information about your individual swallowing function, rather than symptoms alone.

At Marigold Speech & Co., we believe swallowing care should be individualized. There isn’t one diet, strategy, or treatment approach that’s appropriate for every person with dysphagia.

FEES Swallow Studies in Janesville, Wisconsin

You don’t necessarily need to travel to a hospital or large medical center to access an instrumental swallowing assessment.

Marigold Speech & Co. provides outpatient FEES swallow studies in Janesville, Wisconsin. 608-728-7774

Our trained Speech-Language Pathologist FEES Endoscopists provide instrumental swallowing assessments for adults experiencing swallowing concerns.

If you or someone you love is coughing during meals, struggling with certain foods or liquids, experiencing changes in swallowing, or has been told a swallow study may be needed, our team can help determine the appropriate next step.

Because eating and drinking are about much more than nutrition.

They’re part of our routines, our independence, our celebrations, and our quality of life.

If swallowing has changed, you deserve to know why.