Health Encyclopedia:


Modified Barium Swallow

A modified barium swallow (also called a video fluoroscopic swallowing exam) is a test that checks your ability to swallow different consistencies of fluids and solid materials. It also helps in planning treatment, if needed. During the test, a substance called barium is mixed with a variety of materials which you swallow. The material mixed with barium lets the health care providers see the parts involved with swallowing (the tongue, mouth, throat, and esophagus) clearly on X-rays. The test is needed if you have problems swallowing and are at risk of choking or food or liquid going into the lungs (aspiration). It is also needed if you have a feeding tube and the doctor wants to check whether you can go back to eating by mouth.

Before the test

  • Let the doctor know of any medicines you’re taking. This includes vitamins, herbs, and over-the-counter medicines. You may be told to stop certain medicines in the days before the test.

  • Stop eating and drinking 4 hours before the test.

  • Follow any other instructions given by your doctor.


Let the technologist know

For your safety, let the technologist know if you:

  • Are taking any medicines

  • Had recent X-rays or tests involving barium

  • Had recent surgery

  • Have other health problems, especially those affecting the lungs.

  • Have any allergies

  • Are pregnant or may be pregnant

During the test

The test takes place in an X-ray department. It’s done by a technologist trained in radiology. A speech pathologist or feeding specialist is also present. These people are trained to help you with swallowing or feeding problems. A radiologist will be present as well. A radiologist is a doctor who has been trained to use X-rays.

  • You’ll likely be seated in a special chair that is next to an X-ray table. The X-ray table is set upright.

  • You’re given tiny amounts of foods and liquids of different textures to swallow. This may include thin liquids (such as water) or thick liquids (such as milk). You may also be given soft foods (such as pudding). The foods and liquids contain a small amount of barium.

  • The speech pathologist or feeding specialist watches your swallowing. You’re observed carefully for signs of problems as each food or liquid is swallowed. If problems do occur as you’re swallowing, steps are quickly taken to treat these problems. 

  • An X-ray video is also taken as each food or liquid is swallowed. The barium in the foods and liquids shows up clearly on the video.

After the test

  • You may become constipated after the test. This is due to the barium. If you can drink liquids, drinking water may help to prevent this constipation.

  • Your stool will appear chalky white or light for 1 to 2 days. This is a sign of the barium passing from your system.

Call your doctor if:

  • You have severe constipation.

  • You do not have signs of the barium passing (white or light stools) within 24 hours.

Follow-up care

The X-ray video and notes from the test are studied by the health care providers that were present for your test. These results are then discussed with your doctor. Your doctor will meet with you to go over the results. You’ll be advised about what foods or liquids are safe for you. In severe cases of swallowing disorder, it won’t be possible for you to eat or drink safely. This means you’ll need a feeding tube if you don’t already have one. Your doctor can tell you more about this, if needed.


Risks and possible complications of a modified barium swallow include:

  • Liquid going into the lungs (aspiration)

  • Radiation exposure from X-rays

  • Blockage of the bowel due to retained barium

  • Allergic reaction to the barium

Online Medical Reviewer: Fetterman, Anne, RN, BSN
Online Medical Reviewer: Grossman, Neil, MD
Last Review Date: 5/22/2015
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