Dysphagia barium swallow
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2], Hamid Qazi, MD, BSc [3]
Overview
Among patients with dysphagia, barium study is considered the preferred method for evaluating patients as it allows assessment of function and morphology.
Barium Swallow
Barium swallow study findings for dysphagia are as follows:[1][2][3]
Oropharyngeal Dysphagia
- Modified Barium Swallow
- Conducted by a speech pathologist in conjunction with the radiologist
- Different consistencies of liquid and food mixed with barium sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy
- Penetration Aspiration Scale
- Describes the disordered physiology of a person's swallow using the numbers 1-8
Esophageal Dysphagia
Once esophageal dysphagia has been implicated, the next step is either a barium swallow or an upper endoscopy. If there is any suspicion of a proximal lesion such as:
- History of surgery for laryngeal or esophageal cancer
- History of radiation or irritating injury
- Achalasia
- Zenker's diverticulum, a barium swallow should be performed first instead of endoscopy to prevent any perforation. If achalasia suspected on barium swallow, manometry is performed next to confirm. If a stricture is suspected, endoscopy is performed. Any other lesions found are treated as such.
References
- ↑ Chen, Yu Men; Ott, David J.; Gelfand, David W.; Munitz, H. Alexander (1985). "Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: Evaluation of the individual techniques". Gastrointestinal Radiology. 10 (1): 311–316. doi:10.1007/BF01893119. ISSN 0364-2356.
- ↑ Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. "Dysphagia, 11," 93-98.
- ↑ Logemann, Jeri A.; Pauloski, Barbara Roa; Rademaker, Alfred; Cook, Barbara; Graner, Darlene; Milianti, Frank; Beery, Quinter; Stein, David; Bowman, Julia; Lazarus, Cathy; Heiser, Mary Anne; Baker, Theresa (1992). "Impact of the diagnostic procedure on outcome measures of swallowing rehabilitation in head and neck cancer patients". Dysphagia. 7 (4): 179–186. doi:10.1007/BF02493468. ISSN 0179-051X.