Fiberoptic Evaluation of Swallowing (FEES) Test

A FEES test can help a provider identify any problems that occur when food or liquid passes through your child’s throat. The FEES test looks at how your child naturally swallows.

At Gillette Children’s, a speech-language pathologist (SLP) and otolaryngologist/ear, nose, and throat physician (ENT) will lead you and your child through the FEES test. A registered nurse (RN) is also part of the team. First, the ENT might spray the inside of your child’s nose to help numb any sensation they may feel in their nose. Then, a small, flexible tube called an endoscope is placed inside your child’s nose. Because the endoscope has a tiny camera and light, it will show parts of the throat called the pharynx and larynx on a live video screen. While the endoscope is inside the nose, the SLP will tell your child to swallow. In doing so, the SLP can see how well your child swallows their saliva when no food or drink is present.

After that, the SLP will provide your child with food and/or liquids with the scope still inserted. Sometimes the SLP must add a few drops of food coloring to the liquids to see them during the test. With different textures and sizes of food, your child will swallow as they normally would. During this time, the SLP and ENT will observe any potential problems.

There are a few reasons for this type of test. In some cases, a child has trouble swallowing. Similarly, they might feel as if something is always stuck in their throat. These sensations are known as dysphagia, which, if unaddressed, can cause food to go down the airway and lead to choking, pneumonia and persistent drooling.

The FEES test can also help your child’s SLP identify what parts of your child’s mouth and throat might not be working properly and recommend actions to help. Some recommended actions could include avoiding certain foods or liquids or positioning your child’s head and neck to make swallowing safer for them.

If there are foods or liquids that you’ve noticed cause a problem, bring those with you. If your child is breast or bottle feeding, please bring your child’s bottle and expressed breastmilk or formula. This examination can also be completed while your infant is actively feeding at the breast if you are comfortable doing so. Bring any specific bottles, cups, or straws your child uses at home. Your child should stop eating 1 to 2 hours before the procedure.

The FEES test itself usually takes about 20 minutes from start to finish, depending on your child’s individual needs. The entire FEES appointment will be at least 60 minutes – and will include a discussion with your SLP and ENT before, during, and after the test. Together, you will talk about your concerns, review the test results and recommendations, create a care plan, and get answers to any questions you have.

During the test, help your child relax in any way you can. You can hold your child, or if they have a wheelchair, they can stay in their wheelchair if you prefer. We also have supportive seating options if you prefer not to hold your child, or they do not have a wheelchair. Talking to them during the exam and making sure they can see your face is very helpful. When your child stays still and follows the doctor’s directions, it can help the team get more accurate results. You are there to reassure your child and remind them that this will only last a little bit. However, we understand that this isn’t always easy – ask how our Child and Family Services staff can help your child relax during this procedure.

The summary of your visit will include a recommended diet and any recommended follow-up visits with SLP or ENT. Help your child follow this plan and see if it helps get rid of any pain or discomfort they are experiencing when swallowing. If you are preparing their meals, incorporate the recommended diet modifications your SLP and ENT suggest.

For more information about imaging tests at Gillette, please contact our FEES team coordinator at (651) 726-2609.