Cookies were often the treat that Mom and I would share when I would go to the nursing home. You could see Mom’s eyes light up when I pulled out the plastic bag with the chocolate chip goodies. I’d get us both a glass of water and we’d settle in to our visit. Even though Mom had Alzheimer’s disease, these visits were relatively normal as she would try to describe her day and I would share the latest news in my life.
But all that changed when I started to see her cough on a regular basis after eating a bite of cookie. It turns out that she was also exhibiting the same struggles when she ate dinner and the nursing staff alerted us to the possibility that Mom was having difficulties eating. The nursing staff quickly made an appointment for Mom to have a Modified Barium Swallow Study (MBSS) to see whether she was having any issues.
So what is this procedure? According to Danbury Hospital, MBSS is a special type of x-ray that is conducted by a Radiologist and a Speech Language Pathologist (SLP) and is used to determine a person’s swallowing skills. “During this test, your mouth, throat, and esophagus, a muscular tube which connects your mouth to your stomach, is checked,” the hospital’s website stated. “The test will help you, your doctor, and the SLP plan what types of foods and liquids are easier for you to swallow. The SLP will also identify positions and ways to help you swallow more easily and safely.”
The test requires the person to swallow small amounts of food and liquid mixed with barium, a liquid or paste that allows the x-ray device to see images of what’s happening in the person’s mouth, throat and esophagus. “The x-ray captures moving images of the food you are swallowing as it travels from your mouth through your throat and into your esophagus,” the hospital’s website stated. “This test helps identify whether food or liquid is entering your lungs (aspiration). The test also shows which part of your mouth or throat lacks strength or coordination to move the food or liquid in the right direction.”
Both Dad and I got a chance to watch as Mom underwent the procedure. She didn’t find it painful at all. And we got to see on the x-ray how the food moved from her mouth and then down her throat. The medical professional who was doing the x-ray pointed out where her body was having difficulty keeping the food from going through her lungs. This challenge was caused by her Alzheimer’s as well as her chronic obstructive pulmonary disease (COPD) since she couldn’t hold her breath long enough for the opening to the lunch to close and for the food to move smoothly to her stomach. The results of the tests led to Mom being placed on a modified purée diet.
There are some adverse effects possible from the MFSS. These include exposure to a small amount of radiation as well as a slight possibility that the patient is allergic to the barium. And if you’re worried about either of these, there is another option to check a person’s swallowing. A Fiberoptic Endoscoptic Evaluation of Swallow (FEES) provides an alternate procedure in which a thin, flexible tube with a small camera on the end is passed through the hose to the back of the throat. The scope, which is placed high in the back of the throat, is able to view the larynx and surrounding structures. The camera is able to view the person swallowing colored foods and liquids, thus allowing the SLP to make an assessment.