A302 INAPPROPRIATE REFERRALS FOR VIDEO FLUOROSCOPIC SWALLOWING STUDIES; DEFINING THE SCOPE OF THE PROBLEM

Abstract

Background The first step in assessment of dysphagia is determining if it is oropharyngeal or esophageal in origin. Over half of patients with esophageal dysphagia will relate the sensation of food sticking to the cervical area. The timing of the dysphagia and associated symptoms are useful in differentiating between oropharyngeal and esophageal dysphagia with proximal referral. Unfortunately, many physicians are unaware that esophageal dysphagia is commonly sensed in the cervical area and this can lead to inappropriate referrals for videofluoroscopic swallowing studies (VFSS) by Speech Language Pathology (SLP). In our institution, a number of patients referred are found to have predominantly esophageal type dysphagia. This has contributed to long wait times for an SLP assessment and a delay in diagnosis of patients with esophageal dysphagia. The full scope of the problem remains unclear.