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  • Writer's pictureMichelle Shank

Breaking Down Swallow Studies: FEES vs Barium

Updated: Apr 2

In this month's blog we want to discuss the difference between Fiberoptic Endoscopic Evaluation of Swallowing (FEES) versus Modified Barium Swallow Studies (MBSS). We created a simple side by side comparison of both procedures.

Here are some of the reasons we began offering FEES:



Portable and testing can take place by recreating seating and swallowing positions in the home or facility.

Must make an appointment and transport patient to a lab.

Results can be immediate or offered within 1day.

Results can take up to 8 days.

Higher definition video of the larynx and pharyngeal swallow.

Records black-and-white video x-ray of primarily the lateral view of the three phases of the swallow.

No exposure to radiation

Exposure to radiation

Accurately view what is happening during a meal.

Requires barium coated food and liquids. Can be harmful to the patient.

Performed by a Speech Language-Pathologist (SLP). Making it more affordable and easier to schedule.

Performed by a SLP, Radiologist, and Radiology Technician.

Views and implications for assessment



No oral or cervical-esophageal views

Views oral, pharyngeal, and cervical-esophageal stages including function of

pharyngo-esophageal segment (PES) and cricopharyngeus (CP).

Pharyngeal structures before and after the swallow.

​​Structures before, during, and after the swallow.

Views laryngeal function for respiration, airway protection, phonation, and


Cannot view laryngeal function.

​Best view of location and volume of post swallow residue.

​Limited view of post swallow residue.

​Allows view of secretion management and aspiration of secretions.

​Cannot view secretion management.

​Exam time can be extended to assess impact of fatigue or assess variability of


​Exam time is limited due to radiation exposures and scheduling constraints in


​Identify treatment targets, useful as education modality, used to monitor

change, and can provide biofeedback during treatment.

​Identify treatment targets, useful as education modality, used to monitor


Now that Mobile X-ray of Louisiana is offering FEES testing, no appointment and transportation is required to schedule a FEES. All you need is an order from a doctor and you can call us to visit and perform the test. FEES is cost effective because it is portable and only requires the presence of an SLP. Making the FEES test cost effective, convenient for the facility, and puts patient comfort first.


Resource: Nicole T Williams, MA, CCC-SLP, Louisiana Voice & Swallow Solutions

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