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FEES: Fiberoptic Endoscopic Evaluation of Swallowing Now Available at AdventHealth Sports Med and Rehab

A Doctor Speaks to Her Patient in an Exam Room While Going Over Her Charts on a Laptop.

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A fiberoptic endoscopic evaluation of swallowing, or FEES test, is a diagnostic procedure used to gauge how well you swallow. A FEES test can help determine any problems with food and liquid passing through your throat.

AdventHealth Sports Medicine and Rehabilitation now offers this specialized procedure to our patients. We’re here with our experts in speech-language pathology, Erica Bernstein, MA, CCC-SLP and Jessica Ares, MA, CCC-SLP, to walk us through how FEES works and who can most benefit from it.

Can you briefly explain how FEES, or fiberoptic endoscopic evaluation of swallowing, works?

According to divisional speech-language pathology lead Erica Bernstein, “FEES is considered one of the gold standards in diagnosing swallowing problems (dysphagia) as it provides an internal view of the swallow mechanism. This is achieved by a highly trained speech-language pathologist (SLP) who passes a thin, flexible scope with a camera on the end through the patient’s nose. The scope is connected to a laptop and provides us with a vibrant picture of the throat so we can see exactly what is happening when a patient swallows foods and liquids.”

Who can perform FEES and in what settings?

Jessica Ares, speech-language pathology clinical ambassador, says, “A FEES is completed by a specially trained SLP. The trained SLP has completed comprehensive coursework, including classroom and hands-on learning. An extensive mentorship period is also completed prior to achieving competency.”

She continues, “One of the benefits of FEES over other instrumental swallow exams is that it’s portable. It can be completed in a physician’s office, an outpatient therapy center or at bedside in a hospital or care center. These options allow for improved comfort and access to care.”

What symptoms and/or conditions can FEES assess and/or diagnose?

“FEES is an exceptional tool that can reliably diagnose dysphagia,” says Erica.

“Symptoms of dysphagia can outwardly manifest as coughing, choking, throat clearing and/or a wet vocal quality while eating and/or drinking. Because these symptoms can be present for reasons other than a physiological impairment, such as postnasal drip or reflux, FEES allows us to accurately diagnose the presence of an actual swallow problem,” Erica explains.

Who can benefit from FEES and how?

Erica says that anyone with trouble swallowing can benefit from FEES. She states, “Whether it's due to a singular event like a stroke, neurodegenerative diseases such as ALS or Parkinson's Disease, autoimmune illnesses like rheumatoid arthritis or multiple sclerosis, or head and neck cancer, FEES can properly diagnose the presence of a swallowing impairment.”

She continues, “Not only are we able to discern if there is a problem, but we can also glean precisely why there is a problem by determining the exact components of the swallow that are impaired. This allows us to best tailor our swallow exercises to target these specific deficits and improve outcomes.”

“Additionally, FEES allows us to make appropriate diet and liquid consistency recommendations coupled with compensatory strategies to reduce the risks of material entering the airway (aspiration).”

“A repeated FEES can also be completed later on to assess whether improvements in the swallow function have been made after undergoing swallow therapy,” says Erica.

What can you tell us about how FEES will help patients and assist providers at AdventHealth Sports Med and Rehab?

Jessica explains, “Access to FEES at AdventHealth Sports Med and Rehab has allowed us to serve our patients faster and better!”

“Our patients are now able to schedule an appointment for FEES after their initial consult/evaluation. Historically, prior to FEES, access to an instrumental swallow study after an initial consult/evaluation would have taken 3 to 4 weeks.”

“FEES exams are completed in our office. This allows for easier scheduling and improved continuity of care as it eliminates the need for a third party.”

Jessica continues, “FEES provides a real-time, color view of the throat. The results of the exam are immediate. Once deficits are identified, a specific, target-driven plan of care can be developed and appropriate referrals to other providers can be made if needed, like a gastroenterologist or ear, nose and throat doctor.”

“Overall, easy access to testing allows for the quick identification of deficits, the creation of salient goals, and the achievement of faster outcomes,” she maintains.

Here for Your Rehab Care and Much More

Thank you to Erica Bernstein and Jessica Ares for their time and expertise on FEES. If you’re experiencing trouble swallowing and think you can benefit from this procedure, call Call833-787-6755 or click here to be scheduled with a speech therapist that evaluates swallowing. You deserve to feel whole.

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