Videofluoroscopy assessment Patient information leaflet - The Princess Alexandra Hospital NHS Trust

Videofluoroscopy assessment Patient information leaflet (182kB pdf)

Introduction

We hope this guide will answer your questions about your videofluoroscopy assessment. Please contact the team if you require further information via the details at the end of this leaflet.

What is a videofluoroscopy assessment?

A videofluoroscopy is an X-ray examination of your swallowing; it is used to look at how you swallow and aims to find out what difficulties you are having with your swallowing. We do this by using an X-ray video. It produces a moving image of the inside of your mouth and throat as you are eating and drinking, which allows the speech and language therapist to see exactly what is happening as you swallow and identify any difficulties you are having.

What are the alternatives?

No, there is no alternative examination available.

Why do I need a videofluoroscopy assessment?

Your doctor should have explained the reason why you need this test. It will help your doctor to decide on the cause of your symptoms, giving clearer information to the specialists treating you.

What are the risks?

X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor has determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.

Contrast: Very rarely, you may have an allergic reaction to the contrast medium. At any point during or after the examination, if you develop itching or difficulty breathing, tell your radiographer or doctor immediately.

Constipation: There is a possibility that you will have some constipation and you may find that your faeces are white. This is due to the barium we use for the examination. The barium usually clears from your system within 24 hours.

Patients aged 12 to 55, could you be pregnant? X-rays can be harmful to an unborn
baby and should be avoided by patients who are or may be pregnant. It is recommended that the examination is performed within 10 days of the first day of your menstrual period. If your appointment is not within this time or if you think you may be pregnant, please contact the X-ray department before your appointment. When you arrive for your test, you will be asked when your last period started. If it is more than 10 days earlier, your appointment may be postponed.

Breastfeeding: On the day of your examination, you will be given an injection of contrast medium. These agents are low risk contrast agents. A very small percentage of the injected contrast may enter the breast milk but virtually none is absorbed across the gut of the infant. No special precautions are required and you can carry on breastfeeding as normal. However, if you have any concerns you may want to express some breast milk prior to your appointment.

Preparing for your procedure

No preparation is required for this examination. You may continue to eat and drink as you normally would. If this changes, you will be advised appropriately beforehand. If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice. Please contact the booking team before your appointment if:

you plan to use hospital transport or require a hoist transfer
you are or think you may be pregnant
you have had a previous allergic reaction to contrast medium (X-ray dye)
you weigh over 30 stone/190 kilograms
If you are a wheelchair user and it is not possible to remain in your own chair, help is available from our team, or a hoist to transfer you from your chair to the X-ray seat – please let us know in advance.
you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you

If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.

Allergies

If you have asthma or any allergies, especially to barium please inform us in advance.

Medication

Please continue to take all medications as usual prior to your examination.

Getting to us

Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.

When should I arrive?

Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.

Can someone stay with me in hospital?

You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.

The day of the procedure

You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.

The procedure

Your identification will be checked by a radiographer or nurse, and a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes, or other medical conditions you may have, such as thyroid disease and diabetes. The procedure will be explained to you. You will be cared for by one or two speech and language therapists and a radiographer. You will be asked to sit or stand next to an X-ray machine and will be given teaspoons of different types of food and fluid mixed with barium (which you may also drink from a cup). It tastes chalky but is not unpleasant. The speech and language therapists will prepare the food and fluids, guide you through the assessment, and interpret the findings. The radiographer will operate the X-ray machine and recording equipment, take the X-ray, and discuss interpretation with the speech and language therapist. You will be able to rinse your mouth as soon as the examination is finished. Other professionals may be invited to the appointment if needed, for example, a physiotherapist or speech and language therapist. Family/carers are encouraged to be involved in the examination because their involvement and understanding are important in helping you to make any changes to your diet that may be needed.

How long will this take?

This examination can take up to 25 minutes, you should be prepared to be in the department for up to an hour

What if I have a percutaneous endoscopic gastrostomy (PEG)?

If you have a PEG, please let the speech and language therapist know when you arrive. Please bring equipment with you to flush your PEG following the assessment. You will need to flush the PEG 2-3 times during the two hours following the assessment using 50mls of water. If you have any concerns following the assessment about your PEG, please contact the PEG team.

After the procedure

At the end of the procedure, you will be able to go home or when you feel ready. You can eat or drink normally and take your normal medications.

Can I drive after my procedure?

You are able to return to work as soon as discharged from the department.

How soon can I return to work?