Videofluoroscopic Swallowing Study (VFSS)

There are different tests that look at how well you swallow food and liquid. Speech-language pathologists, or SLPs, perform these tests. Learn more about the videofluoroscopic swallowing study.

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Do you have problems swallowing?

You may have already had a swallowing test with an SLP. You may have been tested in the SLP's office, in your home, or in the hospital. The SLP may have checked how well you move your mouth muscles and how clearly you talk. You may have tried different foods and liquids.

Sometimes, the SLP needs more information about how you swallow. You may need another swallowing test—this time in the radiology, or x-ray, department.

You may hear different names for this test, such as:  

  • videofluoroscopic swallowing study, or videofluoroscopy
  • modified barium swallow, or MBS
  • esophagram
  • cookie swallow

The American Speech-Language-Hearing Association, or ASHA, uses the term videofluoroscopic swallowing study, or VFSS.  

About the VFSS

This test helps the SLP see what happens in your mouth and throat when you swallow. The VFSS lets the SLP see:

  • if food goes into your airway instead of your stomach, called aspiration  
  • which parts of your mouth and throat may not work well
  • what kinds of food are safest for you to swallow
  • if certain positions or strategies help you swallow better

Babies and young children can also have this test done. Your SLP can tell you more about what to expect for your child.

Having a VFSS 

This study happens in the radiology, or x-ray, department. You will meet the SLP there. There may also be a doctor there, called a radiologist. A radiology technician will be there to help you get ready and set up the equipment.

You will sit or stand next to an x-ray machine. Your SLP will give you different foods and drinks mixed with barium. The barium makes the food and liquid show up on the x-ray. Barium will not hurt you or stay in your body for too long. The x-ray machine is turned on only while you swallow, so you will not get too much radiation.

You may try soft and hard foods, or thin and thick liquids. You may take small or large bites and sips. You may need to move your head in different positions. You may also try things like swallowing hard. The SLP may record the test and watch it again later.

Children can also have a VFSS. You may need to hold your child in your lap. You and your child will put on vests or covers made of lead to protect you from x-rays. You may feed your baby from a bottle if that is how he eats. Barium is not dangerous for babies or young children. You may see it in the baby’s diaper for a few days after the study.

You should not have this test done if you think you may be pregnant. It is not safe to have x-rays while pregnant.

After the VFSS  

Your SLP and doctor will talk about what they saw during the study. The SLP may show you the video of the test so you can see what happens yourself. Your SLP will use the test results to decide what treatment will help your swallowing. You and the SLP will discuss what foods and liquids are safest, and how to eat them. You may start swallowing therapy soon after the study.

See ASHA information for professionals about the VFSS on the Practice Portal’s Adult Dysphagia page.

Other Resources  

This list does not include every website on this topic. ASHA does not endorse the information on these sites.

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