Bracco Diagnostics Notes Doctors’ Support in Developing Varibar for Assessing Dysphagia

As part of National Dysphagia Awareness Month this June, Bracco Diagnostics is acknowledging speech language pathologists for their support in developing Varibar (barium sulfate) products — imaging agents used to assess swallowing disorders, a problem common among multiple sclerosis (MS) patients.

One in 25 adults is estimated to experience dysphagia, or difficulty swallowing, in the U.S. each year, even though the true prevalence is not fully known and often underestimated, according to the American Speech-Language-Hearing Association (ASHA).

Dysphagia is more common in older people, and can be caused by a number of conditions, including MS, Parkinson’s disease, stroke, traumatic brain injury, dementia, and treatment of head and neck cancer or trauma.

Permanent and transitory swallowing disorders occur frequently in patients with MS. In fact, dysphagia can occur early in disease, even before a person starts to experience characteristic symptoms of MS.

“It is, therefore, important for the MS patient’s primary care physician to refer the patient with multiple sclerosis — with or without a complaint of swallowing problems — for a full workup of his or her oropharyngeal and esophageal swallowing function as soon as the patient has a diagnosis of multiple sclerosis, in order to establish a baseline swallow physiology against which to compare any future changes,” the National MS Society recommends.

Dysphagia can result in several severe complications, such as malnutrition, dehydration, choking, and aspiration pneumonia, which could exacerbate other MS-related symptoms, or even be fatal, if left untreated.

Aspiration pneumonia is caused by inhalation of oral secretions, liquid, or food containing disease-causing bacteria. It is associated with about 10% in-hospital mortality and high hospitalization costs.

Early recognition and treatment of dysphagia can enhance the comfort, safety, and optimal nutritional status of affected patients.

Screening and assessment of dysphagia may be done by speech language pathologists (SLPs), which are healthcare professionals who specialize in the diagnosis and management of dysphagia, and other swallowing and speech disorders.

One of the most common assessment exams for dysphagia is the modified barium swallow study (MBS), also known as a videofluoroscopic swallowing study. During this imaging procedure, the patient swallows preparations of food and liquids of various thicknesses mixed with barium sulfate (a contrast agent), while a radiologist takes X-ray images of swallowing.

This provides a direct and dynamic view of oral, pharynx (throat), and upper esophagus (the tube connecting the pharynx to the stomach) functions.

The procedure allows doctors to identify any abnormalities in swallowing as it progresses from small to large volumes of thin liquids, and thin to thicker viscosities. It is beneficial not only for detecting, but also for assessing dysphagia severity. It provides clinically useful information to doctors for optimizing patient management and preventing complications.

Currently, Bracco’s Varibar products (barium sulfate formulations including liquid, nectar, honey and pudding) are the only contrast agents approved by the U.S. Food and Drug Administration (FDA) to be used in MBS studies.

“In cooperation with leaders of the SLP profession, Bracco developed Varibar products, a line of ready-to-use imaging agents for MBS exams with a fixed concentration of barium sulfate and standardized and pre-measured viscosities, to guarantee reproducibility and accurate comparisons between initial and follow-up studies,” Alberto Spinazzi, MD, senior vice president, chief medical and regulatory officer at Bracco, said in a press release.

“Patients are at the core of what we do at Bracco, and we are proud that we offer products that play a vital role in the management of patients who suffer from dysphagia,” Spinazzi said.