Diagnosis of dysphagia begins with a thorough review of your medical history and a physical exam. Specialists in digestive diseases, ear, nose and throat (ENT), speech-language pathology, and occupational therapy may be involved in your evaluation.
Test results are typically available on the same day or within 24 hours. Efficient testing helps the team quickly arrive at a diagnosis, so your treatment can begin as soon as possible.
Among the tests used to diagnose mouth and throat (oropharyngeal) dysphagia are:
- Modified barium swallow (videofluoroscopic swallow study). A video X-ray shows the mouth, throat and swallowing tube (esophagus) as you swallow a variety of liquids and food mixed with a metallic liquid called barium.
- Fiber-optic endoscopic swallowing evaluation. Your ability to swallow, as well as the sensation in your throat, is evaluated using a special camera (endoscope) and lighted tube.
- Imaging tests. Computerized tomography (CT) or magnetic resonance imaging (MRI) scans.
The following tests may be ordered to look for blockage (obstruction), irritation and motility problems in the swallowing tube (esophagus), and whether the esophagus is pumping too hard or not enough.
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- Barium swallow (esophagram). A video X-ray is used to view movement of liquids and food (mixed with a metallic liquid, barium) through the esophagus when you swallow.
- Endoscopy. Your doctor examines your throat and esophagus with a flexible, narrow tube (endoscope) inserted into your mouth and down the esophagus.
- Esophageal manometry. A small tube (catheter) is used to measure esophageal pressure and record the duration and sequence of muscle contractions.
- pH probe. A thin tube is passed into the esophagus to determine if stomach acids are entering your esophagus (acid reflux).
- Impedance probe. This test measures whether gases or liquids reflux into your esophagus.
- Capsule pH test. A small capsule is attached to the lower end of your esophagus during an endoscopy. The capsule records the amount of time stomach acid refluxes back into your esophagus and whether your heartburn occurs with the acid reflux. Information from the capsule is transmitted to a pager-like receiver.
- Biopsy. A tiny tissue sample (biopsy) of the esophagus is removed and analyzed to distinguish whether you have gastroesophageal reflux disease, eosinophilic esophagitis, or a polyp or tumor.
- Imaging scans. If esophageal cancer is suspected, your doctor may order a computerized tomography (CT) scan, endoscopy, endoscopic ultrasound or positron emission tomography (PET) scan.
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