Modified Barium Swallowing Test

A Modified Barium Swallow (MBS) test is an X-ray that is taken to check the swallowing skills of a client or patient. I recently observed an MBS in a patient who has been cancer-free for nearly 10 years but, was aspirating when he swallowed certain foods and beverages. The MBS was carried out by a Speech Language Pathologist (SLP) at the facility that I’m rotating at currently. The SLP had previously worked with this patient and mentioned that he had developed fibrous tissue along his esophagus, caused by his radiation treatment several years earlier. This was her initial assessment of the patient’s swallowing problems.

Throughout the test, the mouth, throat, and esophagus are checked to see if there are any visible problems with a patient’s ability to swallow.  Before we began the test, the SLP and I put on protective lead vests and a thyroid collar. This was done to shield ourselves from the radiation used in the actual test.

Barium is actually a dry, white, chalky powder that is mixed with water to make thick, almost like the consistency of a milkshake. It is an X-ray absorber and appears white on X-ray film. When swallowed, a barium drink coats the inside walls of the pharynx and esophagus so that the swallowing motion, inside wall lining, and size and shape of these organs is visible on X-ray. This process shows differences that might not be seen on standard X-rays. Barium is used only for diagnostic studies of the GI tract. The use of barium with X-rays contributes to the visibility of various characteristics of the pharynx and esophagus. Some abnormalities of the pharynx and/or esophagus that may be detected by a barium swallow include tumors, ulcers, hernias, diverticula (pouches), strictures (narrowing), inflammation, and swallowing difficulties.

The SLP noted that if she were to have assessed this patient bedside, she probably would have missed that he has aspirating when he swallowed. The MBS really caught the problem that the patient was actually having. It was interesting to see how everything looked through the MBS and to see how problems can go unnoticed.

The SLP was really hands-on and pointed out every part of the patient’s anatomy including his epiglottis, esophagus, stomach, tongue, etc. I can honestly say that working with patients who suffer from dysphagia or who are experiencing temporary swallowing problems is really becoming an interest of mine. There’s so many elements that an RD has to take into consideration, for example consistencies of beverages and foods or physiological problems from cancer treatments.