What is a Videofluoroscopic Swallowing Study (VFSS)?

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What is a Videofluoroscopic Swallowing Study?

A Videofluoroscopic Swallowing Study (VFSS), sometimes called a “modified barium swallow,” is a moving x-ray of swallowing. During a VFSS, you swallow small amounts of foods and drinks mixed with barium (a contrast material that shows up on x-ray). This allows speech pathologists and radiologists to see your swallow in real time, frame by frame. VFSS helps us identify what happens at each stage of swallowing, why problems occur, and what strategies or changes can make swallowing safer and more comfortable.

FAQs

How long does a VFSS take?

A VFSS is usually completed within 20–30 minutes. The actual x-ray exposure is only a few minutes in total. Most of the appointment is spent setting up, positioning you safely, and mixing/trialling different food and drink consistencies.

Is VFSS safe? What are the risks?

VFSS is considered a safe and commonly used assessment. The main considerations are:

• Radiation exposure: VFSS uses x-rays taken in very quick succession to see swallow movements. Because this test involves x-rays, the decision to refer you for this test 9and its associated risks and benefits) should already have been discussed with you by your doctor or specialist. Our role is to keep the exposure time as short as possible while still gathering the information needed.

• Aspiration risk: As with any swallow test, there is a chance that food or drink may enter the airway. This is why the test is supervised closely by a speech pathologist and radiographer.

• Constipation: Because barium is a chalky contrast material, it can sometimes cause constipation or make bowel motions look pale afterward. Drinking extra water afterwards can help. If you are prone to constipation, you may wish to discuss strategies with your doctor or pharmacist before your appointment.

• Allergic reactions: barium is not absorbed by the body and is usually well tolerated. Reactions are extremely rare.

Do I need to fast before my VFSS?

No fasting is required. You can eat and drink normally beforehand.

What should I bring to my appointment?

We will provide standard textures of food and liquid mixed with barium. You are welcome to bring:

• A small amount of any 'problem' foods or drinks you regularly have difficulty with

• Any adaptive cutlery, straws, or cups you normally use

This helps us see how you manage with your usual items.

Can someone come with me?

Yes, you may bring a support person. Due to radiation safety, they may need to wait outside the x-ray room during the actual imaging.

What can I expect in the room?

The test takes place in a radiology (x-ray) suite. You’ll usually be seated in a chair in front of the x-ray machine. A speech pathologist will be beside you to guide the swallowing tasks, while a radiographer operates the x-ray equipment from nearby. The room may feel more “medical” than a clinic room, with a large x-ray machine, monitor screens, and lead shielding. The staff will wear lead aprons to protect themselves from repeated background exposure to x-rays. 

Is the test accessible if I have limited mobility?

Yes. Manual wheelchairs and walking sticks/frames can usually be accommodated, and we can usually adapt the set-up for many people with mobility needs. Unfortunately, hoist transfers are not possible and power wheelchairs are too large to fit safely within the x-ray machine space. If you use a power wheelchair, Swallow Science Melbourne can support you in planning the most appropriate pathway for your swallowing assessment - please let us know.

How long does it take?

The VFSS appointment usually takes around 15-20 minutes in total. Most of this time is spent setting you up, positioning you safely, and trialling different foods and drinks. The actual x-ray exposure time is brief- typically only a few minutes spread across the whole test.

Will I get my results straight away?

In most cases, the speech pathologist will be able to briefly explain what was seen. Please note, the images are then reviewed in detail after the appointment, and a written report is provided to your referring doctor and/or local speech pathologist.

Will I be able to eat or drink after the test?

Yes. Barium passes naturally through the digestive system and does not affect eating or drinking. If any changes are recommended for your swallowing safety, these will be explained before you leave.