The chewable barium tablet slow tracking of oral and pharyngeal swallowing dysfunction

Dysphagia can be due to oral or pharyngeal dysfunction as well as to esophageal causes. Oral and pharyngeal disturbances, however, are more common in older people because of their attendant risks of laryngeal, tracheal, and pulmonary aspiration. To guide any dietary prescriptions it is important to establish whether the patient can best tolerate liquids, soft foods, solid chewable boluses, all, or none of these. It therefore becomes important to supplement liquid barium swallowing studies with soft and chewable boluses mixed with barium. Here I describe the novel introduction of chewable barium tablets in conjunction with routine swallowing studies. Chewable barium tablets, if used properly, are safe, supply needed information, and can shorten the evaluation of oral and pharyngeal dysfunction studies. Because of the granular appearance of the tablets, aspiration due to this solid chewable bolus can be distinguished from liquid aspiration. Moreover, if the barium tablets are swallowed whole, they can help delineate esophageal strictures if the oral and pharyngeal phases of swallowing are normal.