Dysphagia

What tests can be done to investigate Dysphagia?

Depending on your symptoms and your doctor’s findings, he or she may order one of the following tests:

1. Nasoendoscopy
   A thin flexible tube with a camera and light source can be passed via one of the nostrils to look at the back of the nasal passage, throat and voice box. This is a quick test that can be done in the clinic itself to look for abnormalities in the upper aerodigestive tract.
2. Oesophago-gastroduodenoscopy (OGD)
   In an OGD, the doctor will pass a flexible tube with a camera and light through your mouth into your oesophagus, stomach and the duodenum (first part of the small intestine). An OGD is useful for looking for mechanical causes of dysphagia (e.g. tumours, strictures). It is usually a day procedure.
3. Videofluoroscopic swallow (VFS) Study
   This procedure is where a speech therapist examines your oropharyngeal swallow with the aid of a video X-ray. You will be instructed to take a variety of liquid and solid food in an X-ray suite. This is useful to look for anatomical and functional changes in the oral and pharyngeal phases of swallowing. The procedure is not invasive and takes about half an hour.
4. Other Imaging Studies
   Your doctor may order some X-rays or scans. One of these X-rays is a barium swallow. In a barium swallow, an X-ray of your oesophagus and stomach is taken after swallowing some dilute barium to outline the stomach. This test is good to assess for mechanical causes of obstruction such as tumours and strictures.
5. Manometry
   In manometry, a small tube is inserted into your oesophagus to record the pressure and pattern of the contractions of your oesophagus. This test is useful to diagnose functional causes of dysphagia such as achalasia and diffuse oesophageal spasm.