Flexible Endoscopic Evaluation of Swallowing (FEES)
Flexible endoscopic evaluation of swallowing (FEES) is a procedure used to look for problems in the throat and diagnose swallowing difficulties. It involves inserting a small camera through the nose and is carried out as an outpatient procedure.
At a glance
- Paediatric Patients Aged 0+ Seen
What is a flexible endoscopic evaluation of swallowing?
A flexible endoscopic evaluation of swallowing (FEES) is a procedure used to assess how well you swallow. It involves a thin, flexible tube with a small camera and light on the end (a flexible nasendoscope) being inserted up into the nose. It gives your specialists a view of your throat as you swallow and breathe.
A FEES is usually done to assess if you have a problem called dysphagia (trouble swallowing). Dysphagia happens when something is going wrong with the muscles in the throat that control swallowing. It’s important to identify dysphagia, as it can lead to food or fluid going into the lungs or airways (aspiration), which can cause serious health problems, including pneumonia. If there is a weakness in the swallowing muscles, this can lead to food getting stuck in the throat.
You should talk to an ENT specialist about FEES if:
it feels like food gets stuck in your throat when swallowing
you cough when you eat or drink
swallowing is painful
FEES may also be recommended if you have a medical condition that increases your risk of dysphagia, such as:
a neurological condition (for example, Parkinson’s disease, multiple sclerosis),
a respiratory condition (such as Chronic Obstructive Pulmonary Disease (COPD))
a diagnosis of cancer, particularly head and neck cancer
At Welbeck, FEES is carried out as an outpatient procedure in our state-of-the-art Ear, Nose and Throat (ENT) centre. It will be carried out jointly by an ENT specialist and a speech and language/swallowing therapist (SLT).
Paediatrics
We offer appointments to paediatric patients aged 0 to 18. For full information on our paediatrics service, please visit our main Paediatrics page.
More information
At Welbeck, FEES is performed as an outpatient procedure, taking around 20 minutes. You’ll be seated and awake throughout the procedure, and shouldn’t feel any pain.
Your consultant will insert the endoscope into your nose and down into your throat. This may be uncomfortable at the start, and you may feel a sense of tightness in your throat or the need to gag. Gentle, slow breathing with the guidance of your consultant will help you get used to the scope.
Looking at a video screen, your ENT consultant and the SLT will carry out an assessment to see how your throat muscles and voice box are working. You’ll then be asked to drink and eat different types of food. You’ll be assessed to see how safe your swallowing is and how strong and coordinated your swallowing muscles are. The SLT may suggest ways to improve your swallowing during the examination.
At the end of the procedure, the endoscope will be gently removed from your throat and nose. Your ENT and SLT consultants will talk you through what they found straight away. You’ll then receive a report with recommendations and, if required, a treatment plan.
There’s very little risk associated with FEES, and complications are very rare when the procedure is performed by an experienced consultant.
The risks vary based on your age, general health and your reason for having FEES. Your consultant will be able to talk you through any potential risks that could affect you.
At Welbeck, you’ll have a consultation with your ENT consultant and/or your SLT before the procedure. They’ll take you through what is involved and answer any questions you may have. They’ll also ask you about any medications you’re currently taking, as well as any medical conditions you have.
Your specialist will tell you at your consultation if there’s anything else you need to do to prepare.
After your FEES, you’ll be able to go home once your results have been explained to you. You’ll be able to carry on with your normal activities straight away. Your consultant will explain to you if any follow-up appointments are needed, depending on the results of the FEES.
Please contact our Ear, Nose & Throat centre for pricing.
At Welbeck, our ENT specialists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
To book a flexible endoscopic evaluation of swallowing, you must be referred by either your GP, an ENT specialist or your SLT following a consultation with them. Self-referrals are not accepted for this test.
If you would like to schedule a consultation with an ENT specialist or an SLT, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
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Frequently asked questions
A local anaesthetic is not used for FEES, as it can affect your swallowing and alter the results of the test. Our ENT specialists are experts at carrying out FEES and will be able to help and reassure you during the procedure. It may be a little uncomfortable, but it shouldn’t be painful.
If you have any food allergies or foods you’d like to avoid, speak to your specialist in advance of the procedure so they can ensure they have suitable food for you.
Your ENT consultant will discuss alternative procedures, such as X-ray swallow tests or physical examination, with you. FEES is usually recommended over other techniques as it’s safe, quick, and allows swallowing to be fully observed with real-time feedback.
Yes, if you’d like someone to accompany you for support, please discuss this with your consultant. At Welbeck, we can also provide a chaperone service if needed.