How does a modified barium swallow test differ from a regular barium swallow. What preparation is required for a modified barium swallow test. How is the procedure performed and what risks are associated with it.

Understanding the Modified Barium Swallow Test

A modified barium swallow (MBS) test is a specialized X-ray procedure designed to evaluate swallowing function and detect potential issues in the upper digestive tract. This diagnostic tool is crucial for identifying swallowing disorders, also known as dysphagia, and determining safe dietary options for patients experiencing difficulty swallowing.

The test involves ingesting a barium-based contrast solution, which appears white on X-ray images, allowing healthcare providers to visualize the swallowing process in real-time. Unlike a standard barium swallow, the MBS focuses specifically on the oral and pharyngeal phases of swallowing, providing detailed information about the movement of food and liquids from the mouth to the esophagus.

Key Components of the Modified Barium Swallow Test

• Real-time X-ray imaging
• Barium-infused liquids and foods of varying consistencies
• Observation of swallowing mechanics
• Assessment of aspiration risk
• Evaluation of safe food and liquid consistencies

Do healthcare providers use any special techniques during the MBS test? Yes, they often ask patients to perform specific swallowing maneuvers and change head positions to observe how these actions affect swallowing function. This dynamic approach allows for a comprehensive assessment of the patient’s swallowing abilities under various conditions.

Preparing for Your Modified Barium Swallow Test

Proper preparation is essential for ensuring accurate results and a smooth experience during your modified barium swallow test. Following your healthcare provider’s instructions carefully will help maximize the effectiveness of the procedure.

Pre-Test Instructions

1. Schedule the test at a convenient time and location
2. Arrange transportation home after the procedure
3. Discuss current medications with your healthcare provider
4. Inform the provider of any allergies, especially to contrast solutions
5. Complete any required pre-test assessments (e.g., blood tests, urine tests)

Is fasting required before a modified barium swallow test? Generally, patients are advised not to eat or drink anything on the morning of the procedure to ensure the esophagus and stomach are empty, allowing for clearer imaging. However, always follow the specific instructions provided by your healthcare team.

The Modified Barium Swallow Procedure: Step by Step

Understanding what to expect during the modified barium swallow test can help alleviate anxiety and ensure your full cooperation throughout the procedure. The test typically takes about 30 minutes to an hour to complete.

Procedure Overview

1. Patient positioning and initial X-rays
2. Administration of barium mixtures
3. Swallowing various consistencies while X-rays are taken
4. Changing positions and performing specific swallowing tasks
5. Post-procedure barium flushing

Are there any special preparations immediately before the test begins? You may be given a medication to relax your esophagus and prevent spasms, which can interfere with the test results. Additionally, an intravenous (IV) line might be inserted for the administration of fluids or medications if necessary.

Differentiating Modified Barium Swallow from Standard Barium Swallow

While both tests involve the use of barium contrast, there are significant differences between a modified barium swallow test and a standard barium swallow. Understanding these distinctions is crucial for patients and healthcare providers alike.

Key Differences

Which test is more suitable for diagnosing swallowing disorders? The modified barium swallow test is typically more appropriate for assessing swallowing disorders as it provides a detailed view of the swallowing process and can detect aspiration (food or liquid entering the airway). However, the choice between tests depends on the specific symptoms and concerns of the patient.

Potential Risks and Complications of Modified Barium Swallow Tests

While the modified barium swallow test is generally considered safe, it’s important to be aware of potential risks and complications associated with the procedure. Understanding these risks can help patients make informed decisions and promptly report any unusual symptoms following the test.

Common Side Effects and Rare Complications

• Constipation due to barium residue
• Abdominal discomfort or bloating
• Nausea or vomiting
• Allergic reactions to barium (rare)
• Aspiration of barium into the lungs (uncommon)
• Esophageal perforation (very rare)

How can the risk of complications be minimized? Healthcare providers take several precautions to reduce risks, including careful patient selection, proper positioning during the test, and using the minimal amount of barium necessary for diagnostic imaging. Patients can contribute to safety by following pre-test instructions carefully and communicating any discomfort or unusual sensations during the procedure.

Interpreting Results and Follow-Up Care

After completing the modified barium swallow test, patients often wonder about the next steps in their care journey. Understanding how results are interpreted and what follow-up care might entail can help alleviate anxiety and prepare patients for potential treatment plans.

Result Interpretation Process

1. Review of X-ray images by radiologists and speech-language pathologists
2. Assessment of swallowing mechanics and efficiency
3. Identification of any aspiration or penetration events
4. Evaluation of safe food and liquid consistencies
5. Formulation of recommendations for swallowing therapy or dietary modifications

When can patients expect to receive their test results? The timing can vary, but typically, preliminary results are available shortly after the test. A more detailed report and recommendations are usually provided within a few days to a week, depending on the healthcare facility’s protocols.

Potential Follow-Up Interventions

• Swallowing therapy with a speech-language pathologist
• Dietary modifications or texture alterations
• Postural techniques for safe swallowing
• Medication adjustments
• Further diagnostic tests or consultations with specialists

How long might swallowing therapy be necessary? The duration of swallowing therapy varies greatly depending on the underlying cause and severity of the swallowing disorder. Some patients may see improvements after a few sessions, while others might require ongoing therapy for several months or longer.

Innovations and Future Directions in Swallowing Diagnostics

As medical technology continues to advance, the field of swallowing diagnostics is evolving rapidly. New techniques and technologies are emerging that promise to enhance the accuracy, efficiency, and patient experience of swallowing assessments.

Emerging Technologies in Swallowing Diagnostics

• 3D imaging techniques for more detailed visualization
• Artificial intelligence-assisted analysis of swallowing function
• Wearable sensors for continuous monitoring of swallowing patterns
• Virtual reality applications for swallowing therapy
• Non-invasive biomarkers for early detection of swallowing disorders

How might these innovations impact patient care? These advancements could lead to earlier detection of swallowing disorders, more personalized treatment plans, and improved outcomes for patients. For example, AI-assisted analysis could provide more objective and consistent interpretations of swallowing studies, while wearable sensors could allow for long-term monitoring in real-world settings.

Future Research Directions

1. Development of less invasive diagnostic techniques
2. Integration of multimodal imaging for comprehensive assessment
3. Exploration of genetic factors in swallowing disorders
4. Investigation of neuroplasticity in swallowing rehabilitation
5. Improvement of contrast agents for enhanced imaging quality

Will these advancements eventually replace the modified barium swallow test? While new technologies may supplement or enhance current diagnostic methods, the modified barium swallow test is likely to remain a valuable tool in swallowing assessment for the foreseeable future. Its ability to provide real-time, dynamic imaging of the swallowing process remains unparalleled in many aspects.

As research progresses, patients can look forward to more accurate diagnoses, targeted treatments, and improved quality of life for those affected by swallowing disorders. The integration of these innovations into clinical practice will require ongoing collaboration between researchers, clinicians, and patients to ensure that new technologies are both effective and accessible.

Modified Barium Swallow (Precare)

The originating document has been archived. We cannot confirm the completeness, accuracy and currency of the content.

Medically reviewed by Drugs.com. Last updated on Mar 2, 2022.

WHAT YOU NEED TO KNOW:

A modified barium swallow (MBS) is an x-ray procedure used to examine problems with swallowing. Liquid barium is a white, chalky solution that helps healthcare providers see the pictures more clearly. Barium is mixed with liquids and foods to show how they are swallowed. This helps healthcare providers decide what liquids or foods are safe for you to eat. MBS may also detect if food or liquids go into your airways.

HOW TO PREPARE:

The week before your procedure:

• Write down the correct date, time, and location of your procedure.
• Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.
• Ask your healthcare provider if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
• Bring your medicine bottles or a list of your medicines when you see your healthcare provider. Tell your provider if you are allergic to any medicine. Tell your provider if you use any herbs, food supplements, or over-the-counter medicine.
• Tell the healthcare provider if you have ever had an allergic reaction to contrast solution.
• You may need blood, urine, or bowel movement tests before your procedure. You may also need a chest x-ray. Talk to your healthcare provider about these or other tests you may need. Write down the date, time, and location for each test.

The day before your procedure:

Ask your healthcare provider about directions for eating and drinking. You may need to drink clear liquids, such as gelatin, broth, or clear fruit juice.

The day of your procedure:

• Do not eat or drink anything on the morning of your procedure. The pictures may not be seen clearly if your esophagus and stomach are not empty.
• Ask your healthcare provider before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.
• You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
• Healthcare providers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
• An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell healthcare providers if you or anyone in your family has had a problem with anesthesia in the past.

WHAT WILL HAPPEN:

What will happen:

• Your healthcare provider will give you medicine that will help relax your esophagus and prevent spasms. Healthcare providers will take x-rays while you stand, before you drink the barium. You will then be given barium mixtures to drink. Healthcare providers will ask you to sit up, stand still, and move your neck and head as pictures are taken. You will also need to talk, swallow, and change head positions as you drink the mixtures.
• If you are able to swallow liquids without any problems, foods will then be tested. These foods will have different thickness or textures. You may be given barium-coated puddings and cookies, or barium tablets to swallow. Pictures will be taken to see how food goes down your throat, esophagus, and into your stomach. When the procedure is finished, you will have to drink extra liquids. This helps flush barium from your body. More pictures may be taken after the barium has been flushed out.

After your procedure:

You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor you closely for any problems. Do not get out of bed until your healthcare provider says it is okay. When your healthcare provider sees that you are okay, you will be able to go home or be taken to your hospital room.

CONTACT YOUR HEALTHCARE PROVIDER IF:

• You cannot make it to your procedure.
• You have a fever.
• You get a cold or the flu.
• You have questions or concerns about your procedure.

Seek Care Immediately if

• Your symptoms get worse.

Risks

• You may have abdominal cramps, vomiting, or problems swallowing. The barium may become hard and cause a blockage in your bowels. Your esophagus may tear. The barium may leak out of this tear or go down your airway. If the barium goes down your airway, it can block oxygen from your heart and brain. This can be life-threatening.
• Without this procedure, your condition may not be diagnosed. Correct treatment may not be given. Your signs and symptoms may get worse. You may have trouble eating, digesting food, and having a bowel movement.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

© Copyright IBM Corporation 2018 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Modified Barium Swallow Study (MBAS or MBSS)

What is a Modified Barium Swallow and what does it do?

A Modified Barium Swallow Study is an objective evaluation of the oropharyngeal swallow mechanism. Fluoroscopic (real-time moving images) and x-rays are taken while the patient swallows different consistencies of food and liquids that contain barium as a contrast material. The study allows for assessment of swallowing difficulty (dysphagia) that can include aspiration (food or liquids entering the windpipe and reaching the level below the vocal cords). A speech pathologist administers the food and liquids during the study then reviews and interprets the video and makes diet recommendations. The patient is allowed to eat or drink before this study.

Who performs the test?

The examination is performed by a Speech Language Pathologist, a doctor specially trained in Radiology (Radiologist) and a licensed Radiologic Technologist RT (R).

Where does it take place?

At Jackson Hospital in the Radiology Department.

How long does it take?

The average person takes about 15–30 minutes.

What can I do to make it a success?

• Wear comfortable, easy to remove clothing.
• Patients may be required to put a gown on for Fluoroscopy x-ray exams.
• Follow all preparation instructions given to you by your physician’s office. If you have any questions, please call us for clarification. We want your exam to be as successful as possible.

What should I do before the exam?

• There is no preparation required for a modified barium swallow.
• If you are a woman of childbearing age and there is a chance you may be pregnant, please consult your physician before scheduling this exam.

What happens during the exam?

• This exam is done in coordination with the Speech Pathologist.
• The Speech pathologist will give you several foods to eat, each with varying densities and textures to evaluate how well you swallow each. The foods will be coated with barium so the Radiologist and Speech Pathologist can observe you on fluoroscopy as you swallow and they will take images as necessary.

What should I do after the exam?

• You will be given discharge instructions requesting that a mild laxative be taken after the study.
• After the examination, your stool will be lightly colored from the barium for 24 to 72 hours. It is important to remove the barium from the large intestine. If the barium is not removed, it may harden and block the intestine. Drink 6 to 8 glasses (soda pop can size) of liquid after the test to help get rid of the barium. This will also help to keep you from being constipated or dehydrated.

Contact Information:

Hospital (main operator): (850) 526-2200
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BAR-VIPS – a new X-ray contrast agent for the study of the gastrointestinal tract

Gennady Ratobylsky,
Doctor of Medical Sciences
Fryazino, Moscow Region March 25, 2000

drug Bar- VIPS developed by the VIPS-MED company from the city of Fryazino near Moscow.

For the first time in more than a century of history of medical radiology in our country, a finished dosage form based on barium sulfate has appeared. Previously, only a barium suspension was used, which was simply mixed with water before the study. Such a suspension quickly separates and contains large aggregates of particles, which hampered the diagnostic process.

Today’s diagnostic problems in oncology are clearly reflected on the example of the main oncological diseases of stomach and colon cancer. The emphasis on endoscopic detection of this pathology has practically eliminated the possibility of using all modern methods of radiology for this purpose. The main reason for the consistently low diagnosis of early cancer of the stomach and colon, from our point of view, is that the most common anatomical variant of this cancer is an intramural infiltratively spreading tumor, which often proceeds with minimal changes on the mucosal surface.

X-ray examinations using Bar-VIPS, as a rule, made it possible to diagnose any pathological changes in the pharynx, esophagus, stomach, duodenum, small and large intestine.

Colleagues highly appreciated not only the domestic X-ray contrast preparation and the set of chemical reagents for X-ray film processing “RENMED-V”, but also trouble-free (essentially “eternal”) devices for colon irrigoscopy, also manufactured by VIPS-MED. If the chemicals, like the modified Bobrov apparatus, did not undergo significant changes in the production process and still provide the speed and good quality of manual processing of various types of domestic and imported X-ray films, then Bar-VIPS required quality improvement and further improvement of production technologies.

As a result of scientific research and a thorough analysis of practical results, VIPS-MED offers radiologists two types of X-ray contrast agent Bar-VIPS, depending on the purpose of the study:

flocculation in wide values ​​of gastric acidity, low viscosity and good organoleptic properties. The barium suspension is prepared immediately before the study by mechanical (manual) mixing of the dry contents of the package (240 g) with 80 ml of boiled water at room temperature (to a creamy consistency). The manufacturing technology of the radiopaque agent is such that the particles of barium suspension are in suspension for a long time without precipitating. Depending on the purpose of the study / pharynx, esophagus, stomach, duodenum, small intestine or colon irrigoscopy / the amount of dry preparation and water increases strictly proportionally: 3 to 1. Without specifically dwelling on the known methods of studying the digestive tract – they are well described in the literature, I would like only to note that the proposed version of the radiopaque agent allows you to study the fine structures of the mucosa, clearly differentiate the marginal contours of the organ, homogeneously distribute the contrast agent over the inner surface of the stomach, as in the classical study of the macro- and microrelief of the mucosa under conditions of natural double contrasting of the stomach / without additional gas injection, and only due to its own gas bubble under the arch of the stomach /, and with double contrasting of the colon.
1. Bar-VIPS (for double contrasting of the stomach) – the drug is 30% more expensive than the previous one, since a special substance has been introduced into its composition using high technology as an antifoaming agent and 2 packages (1-citric acid, 2 – baking soda) gas-forming mixture.

Such a division of the Bar-VIPS X-ray contrast agent into two types, taking into account the quality of the drug and the economic parameter (price-quality), from our point of view, is advisable, since the second type of Bar-VIPS is more expensive than the first and the need for it, respectively, in a conventional X-ray room less than in the cheaper drug of the first type.

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