Alexis Irazoque, M.S., CCC-SLP
At Expressable, we provide feeding therapy to people of all ages who face challenges with eating and swallowing. Swallowing difficulties can affect anyone, from young children to older adults, and can impact health, safety, and quality of life.
A FEES swallowing test is a safe and simple way to understand how someone swallows and to find out if food or drink is going down the right way. Whether for yourself or a loved one, learning about this test can help you feel more prepared and confident. Let’s explore what happens during a FEES test, why FEES is done, and how to get ready for it.
What is a FEES test?
A fiberoptic endoscopic evaluation of swallowing, or FEES, is a type of swallow study. It helps healthcare providers see how a person swallows and whether the process is safe and working well.
The main purpose of a FEES swallow test is to look for problems like aspiration, when food or liquid goes into the airway instead of the stomach. Aspiration can lead to choking or serious illnesses, like pneumonia.
A FEES test is done by a speech-language pathologist (SLP), also known as a speech therapist, and sometimes with an ear, nose, and throat (ENT) doctor. The test uses a thin, flexible tube called an endoscope. This tube is about the size of a drinking straw and has a tiny camera on the end. The camera is gently placed through the nose and down into the throat.
During the test, the person eats and drinks small amounts of food and liquids, like applesauce or water. The camera shows a clear view of the throat, voice box, and windpipe. This allows the SLP and ENT to watch how the muscles work during swallowing and check if food or liquid enters the airway.
Why is a FEES test done?
The main goals of a FEES test are to:
Check for swallowing problems: See if anything is making it harder or less efficient to swallow.
Look for signs of aspiration: Find out if food or liquid is entering the airway, which can lead to choking or illnesses like pneumonia.
Plan treatment: Help the care team create a safe and effective plan to improve swallowing.
FEES is a quick, safe, and helpful tool for understanding and treating swallowing difficulties in both children and adults. If someone is coughing during meals, having breathing problems, or struggling to eat, a FEES test can help find out why. From there, the speech therapist can suggest ways to make eating safer and mealtimes less stressful.
How to get a FEES swallow test
A doctor must provide an order for the swallow test before it can be scheduled. Once you have the doctor’s order, your care team will help you set up the FEES test at a clinic, hospital, or other healthcare setting. The test itself is quick, usually taking about 15 to 20 minutes to complete.
Your speech therapist will work closely with your doctor before, during, and after the test to make sure you get the right care and follow-up.
How to prepare for a FEES test
If you, your child, or a loved one is scheduled for a fiberoptic endoscopic evaluation of swallowing (FEES), here are some helpful tips to prepare for the test.
General tips for adults and children:
Avoid eating right before the test: Your speech therapist may ask that you avoid food for a few hours beforehand. This helps make sure you're hungry enough to eat during the test.
Dress comfortably: Wear loose-fitting clothes you don’t mind getting messy in case any food or drink spills.
Talk to your speech therapist: Ask what types of food or drink to bring. Foods with color may be used to help the camera see how they move during swallowing.
Expect mild discomfort: A thin tube (endoscope) will be gently placed through the nose. A numbing spray may be used to help it feel more comfortable.
Know what to expect: You’ll be awake and sitting upright for the test.
Special tips for children receiving a FEES test:
Talk with your speech therapist: They’ll help you decide how much food or drink to give your child before the test. Your child should be a little hungry, but not overly hungry.
Bring familiar items: Pack your child’s usual foods, drinks, cups, and utensils so the test can feel more like home.
Comfort items are welcome: Bring a favorite stuffed animal or small toy to help your child feel calm during the test.
Stay with your child: You can remain with your child during the procedure for support.
Preparing ahead of time helps make the FEES test go more smoothly and helps your child feel safe and supported throughout the process.
Expert feeding support for kids
Feeding therapy helps make mealtimes safer and more positive. Our feeding program supports your family from the comfort of your home.
Get startedWhat to expect during a FEES swallow test
You or your child will be awake during a FEES test. The test usually takes about 15 to 20 minutes. Here’s what to expect:
During the FEES test:
Endoscope insertion: A speech-language pathologist will gently place a thin, flexible tube with a camera (called an endoscope) into one nostril and guide it to the back of the throat. A numbing spray may be used to make this more comfortable.
Upright positioning: You’ll be seated upright in a chair. Children and babies may sit in a special seat to help them stay in the right position. People who use wheelchairs can stay in their chair, which will be positioned as needed.
Swallowing evaluation: You’ll be asked to eat and drink different types of food and liquids. Some may have food coloring added so they’re easier to see on camera. The camera sends live video to a monitor so the speech therapist can watch how the food moves through your throat and check for any signs of aspiration (when food or liquid enters the airway).
After the FEES test:
The speech therapist will go over what they saw during the test and explain if there were any swallowing problems. You’ll also receive tips or recommendations to help with safer swallowing. These might include diet changes, special techniques, or exercises to strengthen swallowing muscles.
If you’re unsure about anything, be sure to ask questions before you leave. You might ask:
Did the test show any problems?
Are there any changes to my child’s diet?
Are there strategies we should use at home? (For example, should we try a different feeding position or give solids before liquids?)
The speech therapist is there to help you understand the test results and next steps. If anything is unclear, don’t be afraid to ask questions.
What are the benefits of a FEES swallow test?
A fiberoptic endoscopic evaluation of swallowing (FEES) test has many important benefits. It gives a clear, detailed view of the throat and how the muscles work during swallowing. This helps your speech therapist see exactly what’s happening and identify any problems.
Because the camera provides real-time video, the therapist can give immediate feedback and make recommendations right away.
Another big benefit of a FEES test is that it can be done almost anywhere, even at the bedside. This makes it a great option for people who have trouble moving or traveling to a hospital.
It’s normal to have questions or feel a little unsure about the FEES swallow test. Remember, your doctor and speech therapist will only recommend this test if they believe it will help you or your loved one. If you have any worries or want to learn more, don’t hesitate to talk with your healthcare team. They can also discuss other options if needed.
If you’d like to speak with a specialist or need more information, reach out to our experienced speech therapists at Expressable. We’re here to support you every step of the way.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech therapy practice serving children and adults. We treat all major areas of communication and feeding, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 3,000 5-star reviews from our clients (4.9/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech therapy with personalized education and home practice activities for faster progress.
Communication is more than words. It’s how we share how we feel and show who we are. We’re here to help you or your child do just that.
