Dysphagia diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Feham Tariq, MD [3]


The videofluorographic swallowing study is the gold standard for evaluating the patients presenting with dysphagia. VFSS provides information about delay in initiation of pharyngeal swallowing, nasopharyngeal regurgitation, residue of ingestate within the pharyngeal cavity after swallowing, and aspiration of ingestate.

Diagnostic Study of Choice

Endoscopy Indications

The endoscopy should be performed when the patient presented with symptoms of: [1]

Video Fluoroscopic Swallowing Study

Video fluoroscopic swallowing study, also known as modified barium swallow, is used as the initial study for the evaluation of oropharyngeal dysphagia. VFSS provides the following information about the oropharyngeal swallowing mechanism:[2][3][4][5]

  • Delay in initiation of pharyngeal swallowing
  • Nasopharyngeal regurgitation
  • Residue of ingestate within the pharyngeal cavity after swallowing
  • Aspiration of ingestate{{#ev:youtube|xu_YYOAlZEw}}


  1. Philpott, Hamish; Garg, Mayur; Tomic, Dunya; Balasubramanian, Smrithya; Sweis, Rami (2017). "Dysphagia: Thinking outside the box". World Journal of Gastroenterology. 23 (38): 6942–6951. doi:10.3748/wjg.v23.i38.6942. ISSN 1007-9327.
  2. Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA; et al. (2008). "A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease". J Speech Lang Hear Res. 51 (1): 173–83. doi:10.1044/1092-4388(2008/013). PMC 2894528. PMID 18230864.
  3. Mainie I, Tutuian R, Patel A, Castell DO (2008). "Regional esophageal dysfunction in scleroderma and achalasia using multichannel intraluminal impedance and manometry". Dig Dis Sci. 53 (1): 210–6. doi:10.1007/s10620-007-9845-x. PMID 17549634.
  4. Herbella FA (2012). "Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later". ISRN Gastroenterol. 2012: 903240. doi:10.5402/2012/903240. PMC 3488400. PMID 23150831.
  5. Perry L, Love CP (2001). "Screening for dysphagia and aspiration in acute stroke: a systematic review". Dysphagia. 16 (1): 7–18. PMID 11213249.

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