FEES stands for Fiberoptic Endoscopic Evaluation of Swallowing. This is a procedure to directly visualize what happens in the throat during swallowing. The FEES Endoscopist will be able to determine if food or liquid is going ‘down the wrong way’ (into the airway) or getting stuck anywhere when swallowing. Healthcare providers may have concerns regarding your swallow safety, especially if an individual has been diagnosed with pneumonia.

A FEES usually lasts about 10 minutes. A very thin, flexible tube will be inserted through the nose, allowing visualization of the throat. The tube is attached to a camera that will display the image on a computer screen. The participant will be asked to eat/drink various textures of food/liquid that will be colored with a very small amount of food coloring. The FEES Endoscopist comes to the facility, so individuals do not need travel or transport for this procedure.

The healthcare professional requesting a FEES can prepare by ensuring there is a physician order in the patient’s chart and establish a point of contact at the facility for the day of the scheduled FEES. Patients do not need to do anything special to prepare for the FEES. They may eat and drink up until the appointment time. The patient may be asked to sit up in a chair or have the head of bed elevated as much as tolerated during the FEES.

The Endoscopist performing the FEES will explain the results of the test as soon as it is completed. We provide copies of the diagnostic report at point of service that can be included in the healthcare facility files/EMR.

The risk for any complication is very minimal with FEES. The most likely complication is a sneezing episode. There is a very small risk for a minor nose bleed. Other possible, but highly unlikely, complications include: brief involuntary closure of the vocal folds or a brief drop in blood pressure. Research has been completed using FEES for several decades with very low risk of complications.

There are a number of scenarios when diagnostic swallow imaging is clinically warranted. This includes, but is not limited to:

• Patient has a diagnosis/condition with high risk of dysphagia (i.e. trach)

• Patient with known progression of degenerative condition (i.e. Parkinson’s)

• Bedside swallow eval shows impaired safety/efficiency of swallow

• Need to identify swallow physiology to plan effective treatment

• Need to rule out possible signs at bedside, or silent aspiration

• Need to assess for improvements following dysphagia treatment plan

• Need to rule out dysphagia as a source of medical condition (i.e. pneumonia, globus, weight loss, etc)