Understanding FEES: What to Expect During Your Fiber Optic Endoscopic Evaluation of Swallowing
Doctor explains what to expect during a Fiber Optic Endoscopic Evaluation of Swallowing (FEES) procedure, including preparation, the process, and potential benefits and risks. Learn how this test can help diagnose and treat swallowing issues.
Disclaimer
The medical information in this content is for educational and entertainment purposes only. While Doctor O'Donovan Medical Education Limited always aims to provide accurate information, it does not replace professional medical advice from your own doctor or health provider. Always consult your own healthcare professional for medical concerns.
Doctor O'Donovan Medical Education Limited can not provide individual advice. Never ignore professional medical advice from your own health provider because of something you have read or watched here. Educational resources created by Doctor O'Donovan Medical Education Limited are not a substitute for professional medical advice, diagnosis or treatment.
Topic Breakdown
So, you have an appointment for a Fiber Optic Endoscopic Evaluation of Swallowing (FEES) and you might be wondering what it is and what it involves. If so, then you’ve come to the right place. In this blog post, I will walk you through the key things you need to know and give you an idea of what to expect when you attend your appointment for this procedure.
First, let's start with a brief description of what FEES is. Fiber Optic Endoscopic Evaluation of Swallowing, or FEES, is a detailed swallowing assessment that uses a camera called an endoscope. This procedure is carried out by a team of two people, usually two speech and language therapists or a speech and language therapist and a doctor, such as an ear, nose, and throat specialist. Other staff members may also be present.
Before the FEES test, you may have something sprayed in your nose to help numb the area so that you don’t feel the tube being gently inserted. You’ll be asked to sit upright in a chair or bed. A small, flexible endoscope, which is a tube with a camera on the end, will be passed into one nostril and moved through your nose until a clear view of your throat is obtained. You’ll be able to see your throat, including your vocal cords, on a television monitor if you choose to.
The FEES test has two basic parts. During the first phase, the structure of the throat, known as the pharynx, and the voice box, which is the larynx, may be observed. The second part of the FEES test involves the introduction of food. You’ll be asked to do several things during this examination, such as saying certain sounds, swallowing your saliva, and eating and drinking if appropriate, all while the camera is looking at your throat. Sometimes, food and drink are dyed with a small amount of blue or green food coloring to enable a clear review of it during the swallow. The examination is also recorded so that it can be reviewed later to help develop a treatment plan. At the end of the procedure, the endoscope will be pulled out from the pharynx and the nose.
So, why might you be having this test done in the first place? Essentially, the test is to understand how well you’re swallowing. When you swallow food or liquid, it passes through your mouth and down through parts of your throat called the pharynx and larynx. From here, the food passes through a long tube known as the esophagus before entering your stomach. This movement requires a series of actions from the muscles in these areas and coordination with the muscles of breathing since breathing will pause during a swallow. When you breathe, air passes through your pharynx and larynx too, then travels through a long tube called the trachea before it reaches your lungs. A small piece of tissue called the epiglottis acts like a flap and covers your trachea when you swallow food or drink to prevent them from going into your windpipe and lungs.
A FEES test can help assess if you’re having problems with any part of this process when food and liquid pass through your throat. You might need this test if you’ve got trouble swallowing, medically termed dysphagia. Dysphagia indicates something is wrong with the muscular coordination needed for normal swallowing and can lead to food or fluid going into the airway or lungs, known as aspiration, which can cause pneumonia and other problems. Therefore, it’s crucial to promptly identify and treat dysphagia if you have it.
What are the benefits of doing a FEES? FEES allows examination of your swallowing and voice box in detail, enabling the medical team to try different foods and techniques that may help you swallow more effectively. It also guides the rehabilitation of your swallowing and checks swallow recovery after a period of rehabilitation.
What are the risks of a FEES? Typically, the procedure is very safe. Sometimes, passing the camera through the nose causes mild to moderate discomfort, but once the camera is in position in the throat, the discomfort usually goes away. Other side effects can include a slight risk of a nosebleed, gagging or vomiting, and accidentally swallowing a small amount of spit the wrong way, which may make you cough. The team doing the procedure will run you through a full list of risks before undertaking it.
How do you prepare for this examination? Normally, no preparation is needed. If you’re already able to eat and drink, you can continue to do so. If you’re fed through a tube, this can typically continue as normal. The team carrying out the procedure will let you know what you need to do before you attend. Remember to bring any special cups or feeding utensils you use, and if there are specific foods you find difficult, bring these too. Wear your dentures if you normally have these in when you eat and drink.
What happens once you’ve had the procedure? The procedure takes approximately 10 to 15 minutes. Typically, you can go home or return to the ward immediately after the appointment. The speech and language therapist will give you some basic information and advice immediately after the procedure. They might provide some basic information immediately after the procedure, but otherwise, they will wait to process the results as a team. A further appointment will likely be made with your own speech and language therapist or doctor to discuss the results in more detail and provide further advice.
If your FEES test shows that you’re having problems swallowing, the doctor and speech and language team will work together to develop a treatment plan for you. This may include modifying the types of foods you eat, such as avoiding liquids of a certain thickness, making changes in your positioning while eating, and learning certain methods for swallowing better. It’s essential to work closely with your medical team when developing these plans and carefully follow their instructions to reduce your risk of complications like pneumonia from aspiration if you have dysphagia.
Remember, before you agree to any procedure, ensure you know the name and test of the procedure, the reason you’re having it, what results to expect and what they might mean, and the risks and benefits of the procedure. Always ask the medical team or doctor to explain anything you’re unclear about. Know when and how you’ll get the results and who to call after the procedure if you have any questions or problems.
I hope you found this post useful and informative and now you’ve learned a little bit more about the FEES procedure, what to expect, and what it means. If you did enjoy this post, please remember to like it and leave a comment if you want to share more information or your own experiences about FEES. This is always incredibly helpful and useful. Please subscribe to the channel if you’ve not done so already. If you’re interested in scaling your medical brand on YouTube or sponsoring these videos with your products, feel free to reach out. Thank you for reading and until next time!
Share this article
Partner with Dr. O Donovan
If you would like to partner on a healthcare related campaign, discuss a story or seek my expert opinion please don't hesitate to reach out.