Fibreoptic Endoscopic Evaluation of swallowing (FEES)

You have been referred by your doctor or Speech and Language Therapist (SLT) for a Fibreoptic Endoscopic Evaluation of Swallowing (FEES). For you to better understand and consent to the assessment this leaflet should be given to you prior to your FEES. You can choose not to proceed or if you wish to stop during the assessment, the camera is easily removed. This leaflet aims to explain the risks and benefits of the investigation and what to expect.

What is a FEES?
A FEES provides more detailed information about your swallowing. It involves the use of a small, flexible endoscope (small camera) connected to a monitor screen. The equipment needed for a FEES is portable; this means it can be completed at your bedside or in a clinic.

What does it involve?
The assessment is conducted by two SLTs. You will be sat up in bed or in a chair. A thin flexible nasendoscope (camera) is gently passed through one nostril and moved through your nose and into the upper part of your throat. This provides a good view of your throat muscles and voice box (larynx).

The assessment generally lasts for 10-15 minutes depending on how you tolerate it and how many different food and drink textures are given. You will be asked to do some speech and voice tasks which will give us information about the appearance and function of the anatomy in your throat and voice box.

You will be given food and drink of different textures which may be dyed blue or green so it shows clearly on the camera and the SLTs can watch what happens when you swallow.

The examination is recorded so the images can be analysed in detail later. Where possible, we aim to provide you with interim feedback of ‘first view findings’ pending the full detailed report.

Benefits
You will have already had your swallow assessed by a SLT but further detailed information is required that cannot be obtained by observing you eating and drinking in clinic or on the ward alone without viewing your anatomy from the inside. A FEES can show:

• If food, drink or saliva goes ‘the right way’ into your oesophagus (food pipe).
• If food, drink or saliva is seen to, or is at risk of going ‘the wrong way’ into your trachea (windpipe). This is known as aspiration.
• How well the different parts of your throat work.
• If and what different consistencies of food and drink are safest for you to swallow.
• If there are any strategies or positions which improve your swallowing.

Risks
FEES is a safe assessment; most patients do not experience any problems. Some people experience discomfort when the scope is passed through their nose. This discomfort lessens or disappears once the scope has reached your throat. There is also a small risk of nose bleeds. Please inform your SLT if you have a history of nose bleeds or fainting. Remember, you can ask to stop at any time during the assessment and the camera will be removed.

What happens afterwards?
The SLTs will review the video to give recommendations for how to manage your swallowing. You may be able or wish to view the video whilst your SLT explains the results. The recommendations will be discussed with your healthcare team and a written report will be provided.

Preparation
There is no preparation needed for the assessment. You do not need to stop food, drinks or tube feed prior to your assessment. It is important to inform your SLT if you have any food allergies before the assessment. However, we would encourage regular mouthcare and sitting out in a chair where possible or upright in bed.

Further information
If you have any questions, please contact:

Name: …………………………………………………..

Department:………………………………………….

Tel:……………………………………………………

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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