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​What is Fibreoptic Endoscopic Evaluation of Swallowing (FEES)?

When you eat and drink, food and fluids should go down your throat and into your stomach. However, if you have swallowing difficulties, food and fluids may enter your airway instead.
Fibreoptic Endoscopic Evaluation of Swallowing, or FEES, is a test of your swallowing. It uses a scope to check if food or fluids is entering your airway and/or lungs when you eat or drink.

Why Do I Need to Do a FEES?

• Your Speech Therapist will recommend you to do a FEES to check whether there is food or fluids entering your airway and lungs.
• From the FEES, your Speech Therapist will be able to see which types of food and fluid consistencies are safe for you to eat and drink.
• The FEES can also tell you if there are any swallowing strategies which can help you swallow food and fluids safely and prevent them from entering your airway or lungs.
  

Where Will the FEES Be Done?

• If you are admitted in the hospital, the FEES will be done at your bedside.
• If you are not admitted in the hospital, the FEES will be done in the Speech Therapy Clinic at Clinic B1-C.

How Long Will FEES Take?

• The FEES will take about15-20 minutes.
• If you are doing the FEES at the Speech Therapy Clinic, plan to arrive at least 15 minutes before your appointment time.

What Happens Before FEES?

• There is no special preparation or fasting required before the FEES.
• You will be asked to be wear or bring along your dentures for the FEES.
• Your Speech Therapist will also advise you to take your medications as needed and bring home cooked food if needed for the FEES.

What Happens During FEES?

• You will be seated upright in bed or in a chair.
• A flexible endoscope, with a camera attached at the end, is put into your nose and stops in your throat.
• You will then be given food and fluids of different consistencies to be swallowed. Food and fluids are mixed with blue and green food dye, for the Speech Therapist to see how these are swallowed during the FEES.

• You may be asked to swallow the food and fluids using certain strategies to see if these help make your swallowing safer. For example, you may be asked to swallow twice for one mouthful of food.
• You can stop at any time during the FEES. The Speech Therapist will stop the FEES if there is a high risk of food and fluids entering your lungs.

What Happens After FEES?

• The Speech Therapist doing the FEES will share the results with you. You will be told if you are able to continue or start eating and drinking.
• If you require modified food and fluids, the Speech Therapist or the Speech Therapy Assistant will teach you how to prepare the recommended food and fluid consistencies.
• You will also be taught swallowing strategies if needed for safe swallowing.
• If you are an outpatient, you may be given a appointment with the Speech Therapist to follow-up with swallowing therapy or assessments.

What are the Benefits of FEES?

You will be:

• Able to see which food and fluid consistencies are safe for eating and drinking
• Able to see which food and fluid consistencies are entering your airway or lungs
• Able to see if there are food and fluids entering the airway or lungs without you knowing
• Able to see if swallowing strategies are helpful to stop food and fluids from going into the airway/lungs

What are the Risks of FEES?

You may experience the following:

• Mild irritation of the nose and upper throat area when the scope is put in
• Nose bleeds (Rare)
• Tightening of the throat and voice box may occur in a small number of patients
• Feeling faint with a drop in blood pressure may occur but it is uncommon.
• Infection may develop from the food and fluids entering the airway or lungs
• Food and fluids entering the airway and chance of developing a chest infection