What is a Modified Barium Swallow (MBS) study?

The Modified Barium Swallow Study is a fluoroscopic procedure. It has been called the "gold standard" for evaluating the oral, pharyngeal, and upper 1/3 of the esophageal phases of the swallow and is the only method available today that evaluates the oral phase, pharyngeal phase, and upper 1/3 of the esophageal phase. This is accomplished by observing various consistencies of barium and mixed food/barium as it passes from the mouth to the stomach.


What are the benefits of the MBS Envision Modified Barium Swallow study?

For the patient:

  • Early objective identification of a swallowing problem, which can assist in:
    • determining the safest/least restrictive oral diet
    • identifying compensations to help improve swallowing safety
    • determining an appropriate treatment plan
    • reducing risk of malnutrition, dehydration, and/or weight loss
    • reducing the risk of developing aspiration pneumonia
  • Improving quality of life by returning people to safe oral diets when indicated
  • Reducing the need for tube feedings when appropriate
  • Can be completed in the comfort of the skilled nursing facility (or private home), thereby eliminating the stress, risk, and cost of transportation to/from the hospital or another location.


 For the facility:

  • Reduced cost for procedure

    When the study is completed within the facility,  

    it eliminates the costly transportation of residents to the hospital.

  • Reduced liability

    The resident remains within the safe confines of your  

    facility and does not need to be transferred to another location.

  • Reduced cost of care


    reduces the need for the use of tube feeding and/or  

    thickening agents by returning your residents to a safe and less restrictive

     oral diet.     

  • Timely scheduling of procedure

  • Increased reimbursement

    The MBS Envision Modified Barium Swallow Study can provide documentation needed to justify continued dysphagia therapy and justify a more skilled RUG classification.


Why is an MBS necessary?

a.   Improved health and well-being for your residents.

b.   Allows the facility to offer a wider, more comprehensive scope of rehabilitation services.

c.   Helps to diagnose an oral, pharyngeal and/or esophageal dysphagia that cannot be determined via a clinical or bedside swallow evaluation alone.

e.   It helps to determine if, when, and why aspiration is occurring so that an appropriate treatment plan can be implemented. 



Who actually performs the MBS study for MBS Envision?

A physician and a highly trained speech language pathologist who is employed by MBS Envision, Inc., always will perform the study in conjunction with our consulting radiologist.


Where is the study done?

The study will be performed in a designated area or room of the facility or home that allows for privacy.


What are the risks of the MBS Envision Modified Barium Swallow study to the resident?

The MBS study is an extremely low risk, non-invasive study. It is not appropriate for residents allergic to barium contrast. Given the small amounts of diluted barium that is given during the study, the risk of constipation or impaction is extremely low. The MBS Envision protocol and highly trained SLP assures that potential risk of aspiration is low by utilizing a systematic approach to the procedure; a study would be discontinued for patients who could not safely clear or prevent aspiration.


What emergency procedures are in place?

a.  The evaluating SLP implements appropriate procedures, strategies, and postures in order to reduce the risk of and/or prevent aspiration. 

b.   A licensed physician is present during the entire study.  

c.   Suctioning equipment and oxygen monitoring equipment is available on-site for physician use if needed.  

d.   A team member is CPR certified.

e.   Trained facility staff are nearby to assist if needed.


Are there any special follow-up precautions necessary given the use of barium in the procedure?

a.  The resident should remain upright for at least 20-30 minutes after completion of the study.

b.  If the resident has difficulties with constipation, water or fruit juice (of the appropriate thickness per study recommendations) can be given to reduce the risk of constipation. 



Is there a need for special hazardous waste disposal for barium?

No, barium requires no special handling or disposal instructions. It can be rinsed down a sink or disposed of in a regular waste receptacle.


What is the radiation exposure for the patient?

Radiation exposure to the resident is very minimal and well below the FDA maximum permissible dose. The MBS Envision procedure typically is half to one third of the exposure of the comparable procedure done at the hospital.


What equipment does MBS Envision use? 

The VFSS Imager specifically was designed to only perform the MBS study. It utilizes state-of-the-art technology and produces an optimal image and a recorded study of the highest quality. Lead aprons, lead gloves, suction equipment, and all the supplies needed to perform the study also are brought to the facility.