GI Motility Online

Table 1 - Indications, contraindications and limitations of VFSS

From the following article

How to perform video-fluoroscopic swallowing studies

Gary D. Gramigna

GI Motility online (2006)

doi:10.1038/gimo95

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Indications:
1. To identify normal and abnormal anatomy and physiology of the swallow.
2. To evaluate integrity of airway protection before, during, and after swallowing.
3. To evaluate the effectiveness of postures, maneuvers, bolus modifications, and sensory enhancements in improving swallowing safety and efficiency.
4. To provide recommendations regarding the optimum delivery of nutrition and hydration (e.g., oral versus nonoral).
5. To determine appropriate therapeutic techniques for oral, pharyngeal, and/or laryngeal disorders.
6. To obtain information in order to collaborate with and educate other team members, referral sources, caregivers, and patients regarding recommendations for optimum swallow safety and efficiency.
Contraindications:
1. Medically unstable, lethargic, unarousable, agitated or uncooperative patients.
2. When the information obtained from the study is unlikely to change the patient's management such as in the situation of advanced care preferences, chronic disease, or end-of-life situations.
3. Patient is unable to be adequately positioned.
4. Size of patient prevents adequate imaging or exceeds limit of positioning devices.
5. Allergy to barium (though this is quite rare).
Limitations:
1. Time constraints due to radiation exposure.
2. As the procedure only samples swallow function, it does not fully represent mealtime function.
3. Contrast materials such as barium increase the viscosity and alter liquid and solid food composition and are not natural foods. This may result in discordance between the results of VFSS and real meals.
4. Limited ability to evaluate a fatigue effect on swallowing, unless specifically evaluated.
5. Barium is an unnatural food bolus with potential for refusal.
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