Alexis Irazoque, M.S., CCC-SLP
Feeding and swallowing disorders affect a person’s ability to safely eat and drink. They can occur at any age, from young children to older adults. These challenges can significantly affect a person’s nutritional intake, health, safety, and overall quality of life.
If you or a loved one has problems with feeding or swallowing, a modified barium swallow study (MBSS) may be recommended. Read on to learn what happens during an MBSS test, why it’s used, and how to prepare for your or your child’s MBSS.
What is a MBSS and why is it used?
A modified barium swallow study (MBSS) is an imaging test that provides a real-time video of the swallowing process. It uses X-ray technology to help healthcare providers identify or rule out aspiration.
Aspiration occurs when food or liquid enters a person’s airway, instead of traveling down the esophagus to the stomach. Aspiration can lead to choking, near-choking experiences, and serious respiratory illnesses like pneumonia.
During an MBSS study, a person is asked to eat and drink substances such as water, applesauce, and crackers. The X-ray captures a moving picture of how the food and liquid move from the mouth, through the throat, and into the stomach. The swallow study is painless and typically quick.
How to get an MBSS test
If a swallow study is recommended, it will likely be by a speech-language pathologist, also known as a speech therapist. However, the study will require an order from a doctor. Once you have the order, you can schedule the MBSS at a hospital or a specialized imaging center. Your speech therapist will work closely with the doctor throughout the process of having the MBSS.
How to prepare for an MBSS
If you, your child, or a loved one is scheduled for a modified barium swallow study, here’s how to prepare.
Avoid wearing metal during the swallow study: Don’t wear jewelry or clothing with metal near the neck area.
Bring a list of medications: Bring a list of medications you’re currently taking, including the type (e.g., whether they’re coated, capsules, etc.).
Share your mealtime routines: Discuss your mealtime habits so the study can replicate them. For example, if you wear dentures during meals, bring them along.
Share any allergy information: Tell the healthcare team if you have any allergies.
Dress comfortably: Wear loose-fitting clothing that you don’t mind getting dirty, as barium may spill during the procedure.
Avoid eating right before the study: It’s best to have an empty stomach before the procedure.
Special instructions for children
Bring items that your child uses to eat or drink: This may include vessels, cups, and utensils that your child uses at home, and anything else your child usually has or plays with during meals.
Bring a variety of foods: Pack foods of different consistencies, including some of your child’s favorite foods and foods that you’re not sure they can safely eat. While the hospital can provide some foods, bringing what your child is used to will help mimic their typical eating experience.
Talk with your speech therapist: They can suggest specific items to bring.
What to expect during an MBSS swallow test
You will be awake during the MBSS. The swallow study should take about 15 minutes or less. Here’s a brief overview of what to expect during an MBSS procedure:
You’ll be given a liquid to drink that’s mixed with barium. Barium is a white substance that makes the liquid visible on the X-ray.
The study may involve trying different head positions or using specialized cups to determine the safest way to swallow.
The radiologist may give you a lead blanket to wear for protection from the X-ray.
A speech therapist will analyze the X-ray in real-time, identifying any swallowing issues.
If you are a parent or caregiver of a child receiving an MBSS, you will likely stay with your child during the test.
What are the benefits of an MBSS swallow test?
There are many benefits to doing a modified barium swallow study. While certain signs of aspiration, such as coughing or watery eyes, are easy to notice, “silent aspiration” can be harder to detect. Silent aspiration occurs without obvious symptoms. This is one reason an MBSS test can be crucial in diagnosing swallowing difficulties.
If a person often has respiratory illnesses or struggles during meals, an MBSS can help identify the cause. Then, your speech therapist and healthcare team can recommend diet changes for safer eating and less stressful mealtimes.
It’s natural to have concerns about the MBSS, especially since it involves X-rays. However, a doctor or speech therapist will only recommend this study if the benefits outweigh the risks. If you have any concerns, talk about them with your healthcare provider. They can also explore alternative tests if needed.
