🎙️ Welcome back to Swallow Talk!

I am so excited about today’s conversation because it builds beautifully on our episode from last week.

Last week, I had the incredible opportunity to speak with Dr. Reza Shaker, where we talked about esophageal dysphagia and the physiology of the esophagus- really laying the foundation for why the esophagus matters when we think about swallowing as a whole.

And that conversation naturally leads us into today’s topic: How do we actually screen the esophagus during our clinical swallowing assessment?

Today, I’m very excited to welcome Dr. Stephanie Watts, PhD, CCC-SLP.

Dr. Watts is an SLP researcher whose work has made an important contribution to how we think about esophageal screening within the modified barium swallow study. Her research has focused on swallowing physiology, esophageal screening, and helping clinicians recognize when findings may warrant further evaluation.

She is also a key researcher behind the Robust Esophageal Screening Test - REST, a standardized approach to esophageal screening during the MBSS.

And I think this is such an important conversation for SLPs because we spend so much time analyzing the oral and pharyngeal phases of swallowing- but what happens after the bolus passes through the UES matters too.

Dr. Watts and her colleagues have conducted important research examining how SLPs can incorporate standardized esophageal screening into the MBSS and how this information can contribute to a more comprehensive understanding of swallowing dysfunction.

We talk about:

🔹 Why SLPs should consider the esophagus as part of the swallowing continuum

🔹 Why esophageal screening matters during the MBSS/VFSS

🔹 The Robust Esophageal Screening Test (REST) and the importance of standardization

🔹 What SLPs should be looking for when screening esophageal bolus flow

🔹 How REST was developed and studied

🔹 What research tells us about the diagnostic accuracy of a standardized esophageal screen

🔹 Where esophageal screening fits within SLP clinical practice and scope of practice

🔹 When findings should prompt further evaluation or referral

🔹 How standardized screening can support multidisciplinary dysphagia care

Dr. Watts’ research demonstrated that a systematic, multi-texture esophageal screening protocol interpreted by SLPs can identify patients who may have esophageal abnormalities and potentially facilitate appropriate multidisciplinary follow-up. Her subsequent work has also examined how REST can be implemented in clinical settings. (PubMed)

Importantly, esophageal screening is not the same as diagnosing an esophageal disorder. The goal is to recognize potentially abnormal findings and communicate appropriate information to the broader medical team.

This conversation is especially relevant for SLPs performing MBSS/VFSS who want to think beyond the oropharynx and consider the swallowing process as a whole.

Research discussed:

Watts, S., Gaziano, J., Jacobs, J., & Richter, J. (2019). Improving the diagnostic capability of the modified barium swallow study through standardization of an esophageal sweep protocol. Dysphagia, 34(1), 34–42. (PubMed)

Watts, S., Gaziano, J., Kumar, A., & Richter, J. (2021). Diagnostic accuracy of an esophageal screening protocol interpreted by the speech-language pathologist. Dysphagia, 36(6), 1063–1071. (PubMed)

Watts, S., Gaziano, J., Kumar, A., & Richter, J. (2023). The modified barium swallow study and esophageal screening: A survey of clinical practice patterns. American Journal of Speech-Language Pathology, 32(3), 1065–1082. (PubMed)

Gregor, J. W., & Watts, S. A. (2023). Implementation of esophageal screening in an outpatient hospital-based setting: A quality improvement project. American Journal of Speech-Language Pathology, 32(6), 2603–2614. (PubMed)

Disclaimer: This conversation is for professional education and discussion and is not intended to replace individual clinical judgment, institutional protocols, or medical evaluation.

#SwallowTalk #Dysphagia #SpeechLanguagePathology #SLP #EsophagealDysphagia #EsophagealScreening #REST #VFSS #MBSS #Swallowing #DysphagiaResearch