Impressions of Esophageal Clearance Under Two Conditions During the Modified Barium Swallow Study: A Pilot Study

Background: Esophageal visualization is an important aspect of the Modified Barium Swallow Study (MBSS). Sequential swallows have an impact on esophageal clearance; however, standard cueing for esophageal clearance does not limit the number of times a patient swallows. We aimed to determine the potential impact of providing additional verbal cues related to the number of times to swallow on impressions of esophageal clearance during the MBSS. Methods: Standard of care MBSS were performed using the Modified Barium Swallow Impairment Profile (MBSImP). In the standard MBSImP condition, participants were instructed to “swallow when you’re ready.” Whereas, in the experimental condition, participants were instructed to “only swallow one time.” We report a combination of MBSImP component 17 scores (esophageal clearance) for both conditions. We performed tests of association and determine if statistically significant associations exist between MBSImP component 17 scores under two conditions. Results: Thirty-six participants qualified for this study. Esophageal clearance scores changed in 14 (38.9%) of participants when comparing between the two conditions. For participants with score change, 57.1% had an increase (more altered clearance) and 42.9% had a decrease (more typical clearance) in scores. A significant association was identified for esophageal clearance (component 17) scores in the standard versus experimental conditions ( P < 0.0001). Conclusion: Impressions of esophageal clearance (component 17) changed in 38.9% of participants in the experimental condition, with over half of those whose score changed indicating more atypical esophageal clearance. Our results illuminate the need for further study into the contexts in which impressions of esophageal clearance during the MBSS are made.