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Tests and diagnosis
By Mayo Clinic staffYour doctor will likely perform a physical examination and may use a variety of tests to determine the cause of your swallowing problem.
Tests that your doctor or a specialist uses may include:
- X-ray with a contrast material (barium X-ray). For this test, you drink a barium solution. This solution coats the inside of your esophagus, allowing it to show up better on X-rays. Your doctor can then see changes in the shape of your esophagus and can assess the muscular activity. Your doctor may also have you swallow solid food or a pill coated with barium to watch the muscles in your throat as you swallow or to look for subtle blockages in your esophagus that the liquid barium solution may not identify.
- Dynamic swallowing study. In this test, you swallow foods of different consistencies that have been coated with barium. This test provides a visual image of these foods as they travel through your mouth and down your throat. It's helpful for diagnosing oropharyngeal dysphagia because your doctor can see if there are any problems with how the muscles of your mouth and throat work when you swallow. This test can also detect if any material goes into the breathing tube (aspiration).
- A visual examination of your esophagus (endoscopy). A thin, flexible, lighted instrument (endoscope) is passed down your throat so that your doctor can view your esophagus. Your doctor may also do a test called a fiber-optic endoscopic evaluation of swallowing (FEES), which uses a small lighted tube (flexible laryngoscope) placed in the nose. This allows your doctor to see what's going on when you swallow.
- Esophageal muscle test (manometry). In manometry (muh-NOM-uh-tree), a small tube is inserted into your esophagus and connected to a pressure recorder. This allows measurement of the muscle contractions of your esophagus as you swallow.
References
- Dysphagia. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/dysph.asp. Accessed Sept. 2, 2011.
- Swallowing trouble. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/swallowingTrouble.cfm. Accessed Sept. 2, 2011.
- Dysphagia. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch012/ch012b.html. Accessed Sept. 2, 2011.
- Feeding and swallowing disorders in children. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/swallowing/FeedSwallowChildren.htm. Accessed Sept. 2, 2011.
- McQuaid KR. Gastrointestinal disorders. In: McPhee SJ, et al., eds. Current Medical Diagnosis & Treatment 2011. New York, N.Y.: The McGraw-Hill Medical Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6395. Accessed Sept. 8, 2011.
- Hirano I, et al. Dysphagia. In: Longo DL, et al., eds. Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Medical Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9112744. Accessed Sept. 8, 2011.
- Garcia JM. Managing dysphagia through diet modifications. American Journal of Nursing. 2010;110:26.
- Mendelson MH. Esophageal emergencies, gastroesophageal reflux disease, and swallowed foreign bodies. In: Tintinall JE, et al., eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Medical Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6360571. Accessed Sept. 8, 2011.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Sept. 13, 2011.
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