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IDENTIFY DYSPHAGIA

HOW BARIUM SWALLOW TESTS CAN IDENTIFY DYSPHAGIA?

For people who have difficulty swallowing or suspect that they have dysphagia, a visit to a doctor is necessary to obtain a correct diagnosis. Swallowing problems are identified by physical examination as well as through various barium swallow tests.

What is a barium swallow study?

A barium swallow study is essentially an X-ray study of the upper gastrointestinal tract, particularly the pharynx (back of mouth and throat) and the esophagus (the hollow tube of muscle extending from below the tongue to the stomach). These bodily structures cannot be observed well via X-ray on their own; these structures do not contain substances that would show up on X-ray film. Therefore, a material called barium is used to create a clearer picture. 

Barium, specifically barium sulfate, is a chemical compound that absorbs X-rays. Those areas show up white on X-ray film. This dry, white, chalky powder is mixed with water to make a thick, milkshake-like drink. When a patient ingests the liquid, it coats the inside walls of the pharynx and esophagus so that these areas and swallowing motion are visible via X-ray.

In another type of test, patients may be asked to consume barium-coated foods of different consistencies. This test provides an image of the foods as they travel down the throat and into the stomach instead of focusing on the walls of the esophagus. Barium-coated food exams can identify blockages that the liquid barium solution may not indicate.

Types of problems that can be detected though a barium swallow test

Barium swallow tests can aid in identifying structural abnormalities of the upper GI tract as well as motion difficulties as the patient swallows. 

Structural abnormalities:

- tumors 

- ulcers

- hernias

- diverticula (pouches)

- strictures (narrowing)

- inflammation


Swallowing difficulties:

- muscles of the esophagus and pharynx do not behave correctly 

- mouth and throat muscles do not coordinate properly

- food enters the patient’s trachea (windpipe)


Barium studies can also be used to diagnose gastroesophageal reflux disease (GERD).

Risks associated with a barium study

There are a few specific situations in which a barium study may be risky. For one, if a patient has been exposed to radiation recently, they should inform the doctor of past scans and radiation treatments. Risks associated with radiation are generally related to the cumulative number of X-ray examinations or treatments over a long period.

For women who are pregnant, notify your doctor before participating in a barium swallow study. Patients who are allergic to medication, contrast dyes, iodine, or latex should tell the doctor about these.

What can I do once swallowing difficulties have been identified?

Once dysphagia is identified, there are several courses of action the patient can take to assist in proper food intake:


1. Practice exercises and swallowing techniques. A speech-language pathologist can analyze your condition and recommend exercises that will help coordinate your swallowing muscles or stimulate the nerves in charge of those actions. 


2. Purchase eating and drinking aids. Bionix Health at Home designed several tools that aid in feeding:

    a) SafeStraw™ Drinking Aid for Thick Liquid – This straw contains a valve that limits the volume of liquid a user can take into their mouth           at one time, which reduces the risk of coughing and choking.


    b) SafeStraw™ Drinking Aid for Thin Liquid – Can be used for thinner liquids than the above SafeStraw.


    c) Controlled Flow® Baby Feeder – This infant bottle has an adjustable flow rate with several stages slower than a standard Stage 1 nipple.               The rate can be adjusted without removing the bottle from the baby’s mouth, maintaining a good seal between the baby’s lips and the                   nipple.


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References:

- Barium Swallow: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/barium_swallow_92,P07688/

- Dysphagia Tests and Diagnosis: http://www.mayoclinic.org/diseases-conditions/dysphagia/basics/tests-diagnosis/con-20033444

- Barium Swallow/Meal/Follow Through: https://patient.info/health/barium-swallowmealfollow-through