The Use Of Swallow Study For Dysphagia

By Janet Russell


Dysphagia is the medical term for difficulty in swallowing. Different degrees of this problem exist. The problem may be encountered with the swallowing of solids only or with all types of foods including liquids. Regardless of severity, it is important that investigations are carried out to determine what the cause is. The swallow study for dysphagia is one of the most important preliminary investigations for an individual with this kind of problem.

Not all patients that have a problem with swallowing need to be subjected to the test. The decision will be arrived at after considering various factors that include, among others, the medical history and the findings on the physical examination. Some of the information that may be used in decision making include the duration of the condition, progression and whether it relates to solids only or to all food types.

Lesions found within the esophagus are a common cause of this problem. Cancerous growths and polyps tend to obliterate the lumen and cause progressive dysphagia as the diameter is gradually reduced. Inflammatory conditions caused by ingestion of alkalis, acids or infections result in stricture formation which subsequently affects swallowing. Another possible cause is the presence of varices (enlarged veins). There may or may not be associated pain in all of these instances.

Before you have the test, your doctor will take you through some preparation. This is fairly simple and is carried out by the patient under instructions. The most important aspect of this process is to reduce the fiber content in the food for two to three days before the test is conducted. The next thing that you need to do is to undergo an overnight fast (the last meal should be taken before midnight on the morning of the test).

The test involves exposure to x-rays. You will be asked to drink a cup of barium sulfate suspension, a radiopaque solution. What this means is that the rays do not penetrate it. When it fills the lumen of the esophagus and the rays are turned on, a corresponding shadow is formed on the film. The outline of this shadow is what provides the important information. An ulcer appears as a projection from the image and a tumor appears as a depression.

There are very few complications if any. Some of those that have been reported include anaphylactic reactions induced by the barium sulfate. Fortunately, this is very rare and can be avoided if one is tested beforehand by ingesting just a small amount before taking the entire cupful. Another problem that may be encountered is constipation. This usually resolves spontaneously within a few days.

Regular meals can be restarted as soon as the test has been completed. Due to the underlying risk of constipation, it is customary for some doctors to prescribe a light diet for a couple of diet. You may notice chalky white staining of your stool for a few days. This should not be a cause for worry as it is simply the effect of barium sulfate being released by the body.

The management of your condition will be determined by the findings of your doctor as well as the report from the radiologist. It is not uncommon for the results to be normal. Your doctor may recommend additional tests (such as endoscopy) and also refer you to specialists such as speech and language therapists, neurologists, gastroenterologists and otolaryngologists among others.




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