Swallowing Rehabilitation Research Lab

Rationale for Standardized Recipes

The purpose of the recipes is to promote the use of a standard level of barium concentration in videofluoroscopy. This should achieve two primary objectives:

  • First, the bolus should be clearly visible on the videofluoroscopy, and that level of “opacity” or darkness should be constant (it is a factor of the concentration of the barium).
  • Second, by using a constant concentration of barium, we aim to make sure that residue, if it is seen, is not an artifact of the barium itself. Higher concentrations of barium are designed to coat the mucosa and so can add to the presence of residue. The goal is to make sure that this risk is held constant across patients and studies.

Notice to Clinicians Preparing Stimuli

In Canada, due to the lack of available barium products intended specifically for the VFSS and imaging of the oropharynx, it is common to mix other gastrointestinal imaging preparations for use in a VFSS. Mixing barium preparations in a way that differs from the manufacturer’s label or using them in a different examination context constitutes an “off-label” use of the product. Essentially, this means that this use of the product has not received specific approval from a regulatory agency. Clinicians are advised to check product labels for intended use and to explore the implications of off-label use with their employers and local regulatory bodies.

In these recipes, concentrations of 40%w/v or 20%w/v barium have been used.  A 40% w/v concentration matches the concentration of VaribarTM, a barium suspension product developed specifically for imaging of the oropharynx during VFSS and marketed in the United States by Bracco.  A 20% w/v concentration has been suggested in the dysphagia research literature to be more similar to water (a “true thin liquid”) than thin Varibar.

Click the following links below to find the corresponding recipes for the concentration and thickness you require:

40 % w/v thin liquid barium recipe

20 % w/v thin liquid barium recipe

General Instructions for Thickened Liquid Barium

Barium calculator