Barium Test with Throat Paralysis
Question: I am in the hospital right now with COPD. I had Bulbar polio and my throat is paralyzed. The doctor insists that I have a barium swallow test to see how thick my food should be.
Dr. Bruno’s Response:
A video swallow study would let the doc see what thickness of liquid you need that doesn't pool in your throat or go down toward your lungs. If you're coughing or choking or have had pneumonia I would recommend the study. Please tell the doc if you have blood pressure issues.
Another option is to work with a speech therapist, starting with a thick liquid that you know DOES NOT cause trouble swallowing then dilute it until you find the "thinness" that causes symptoms.
Speech therapists do far more than help you deal with speaking. They teach swallowing techniques like turning the head, tucking the chin, thickening liquids.
If you're having significant swallowing problems but don't know what's happening in your throat with a video swallow study you can't compensate except by trial and error. It's like bracing a leg without doing a manual muscle test. But trial and error with thick to thin liquids is better than no trial at all.
There are different kinds of swallowing problems. The "throat" trouble -- swallowing thin liquids -- is due to the poliovirus damaging the swallowing control centers in the "bulb" of the brain, the brain stem. Every polio survivor had "bulbar" polio, i.e., damage to the brain stem, but some had more damage than others. You may remember when you first had polio that liquid didn't go down but came out of your nose!
Please remember: not all swallowing problems are due to polio. Anyone can develop a pouch in the esophagus that holds liquid or food. That's why a video swallow study is important if you have consistent or intermittently severe swallowing issues.
By the way, there is NO ANESTHESIA with a swallow study. It's not painful. You couldn’t eat or drink barium if you were asleep!