Which of the following is an indication for video fluoroscopic swallow study: Esophageal dilation, evaluation of esophageal motility, or gastroesophageal reflux?

• A. All of the above
• B. Esophageal dilation
• C. Evaluation of Esophageal motility
• D. Gastroesophageal reflux

Answer: (D)

Video fluoroscopic swallow study is used to observe the actual swallow in motion and, importantly, to watch for reflux of material entering the pharynx or airway during or after the swallow. This makes gastroesophageal reflux something you can evaluate during the exam, helping determine whether reflux could contribute to penetration or aspiration and affect swallowing safety.

Esophageal dilation and evaluation of esophageal motility aren’t primary uses for VFSS. Dilation is a structural issue typically assessed with a dedicated esophagram or endoscopy, not the dynamic oropharyngeal-focused view of VFSS. Esophageal motility requires specialized testing like manometry to measure peristaltic function, which VFSS cannot reliably provide.

For GERD, VFSS can show reflux events during swallowing, but definitive GERD evaluation often relies on pH monitoring or impedance testing over extended periods.