FEES (Fibre Endoscopic Evaluation of Swallow)

Speech and Language Pathologists (SLP) are experts in the assessment and treatment of swallowing problems (dysphagia). You have been referred to the SLP because you have had some difficulties swallowing because of surgery or a medical condition.

A FEES test provides a clearer picture of what is happening inside your throat when you swallow. The test will help health professionals understand why you are having problems swallowing and decide how best to manage these problems. SLP have received a speciality training in this procedure.

1. What is a FEES (Fibre Endoscopic Evaluation of Swallow)?

• During FEES, the SLP uses a very small tube-like camera with a light on the end. This is called an endoscope which passes through the nose to view your throat. The endoscope is flexible and connects to a computer and video monitor or screen.
• Your swallowing test is usually recorded so that it can be watched again later and the SLP will provide a report.

2. Why have a FEES?

When you have a bedside swallowing test the SLP cannot see what is happening inside your mouth and throat. FEES can help the therapist find out:

• If food or saliva is going into your airway instead of your stomach, called aspiration
• What parts of your mouth and throat may not be working well
• What kinds of food are safest for you to swallow
• If certain positions or strategies help you swallow better
• If there are any pooling of secretions/phlegm in throat
• Movement of laryngeal components in verbalisation

3. Who will be there during the test?

• There will usually be a team of two people present during your test who are SLP. Extra members of the healthcare team or your carers may observe the procedure.
• The equipment needed for the FEES can be moved to different places, which means that it may be done at your bedside, or you may go to a clinic to have it done.

4. Is there any preparation for the test?

There is no preparation necessary for this test. If you are already eating and drinking, then you may continue to do so right up until the FEES is carried out.

5. What happens during the test?

• You will be seated or propped up in bed or on a chair so that you are comfortable.
• The tube will be gently inserted through your nose and will bend to look into your throat.
• You will be asked to vocalise (talk or make a sound) to view the movement of your vocal cords and then given something to eat and drink.
• We add blue food dye to the food and fluids to be able to see if food or drink has gone the wrong way. The SLP can see a picture of your throat on the computer screen and can watch the food/drink as it passes through. The test normally takes around 5-10 minutes.

6. Are there any risks during the procedure?

• FEES is a safe test with very few problems reported, however if you have a history of nose bleeds or fainting, please let your therapist know prior to the exam.
• FEES can cause mild to moderate discomfort as the scope is inserted but once it is in position this feeling normally improves. The procedure should not be painful.
• During the examination if you are seen to aspirate, this will be monitored, and additional medical support is in place if needed.
• We may ask you to try swallowing different types of foods or liquids, or to swallow in a different way to try to reduce the amount of aspiration. We will be careful to keep the amount of aspiration to a minimum during the test.

7. What happens after the test?

• The SLP will tell you about the results of the test and may even show you the video so you can see the test yourself. Out-patients can go home immediately after the appointment as there are no after-effects.
• The SLP will use the results to plan your treatment and if indicated, will talk to you about what kinds of food and drink are the safest for you.
• Results of the test will be reported back to the relevant healthcare staff and a written report will be added to your medical notes. If we notice anything regarding the structure of your larynx, we may ask the Ear, Nose and throat specialist for a second opinion.