Not to be confused with swallowing dysmotility and aspiration, the first examination is the barium swallow. This diagnoses anatomical abnormalities of the esophagus and provides a very limited functional evaluation. Endoscopy may ultimately be required. If aspiration and swallowing dysmotility are suspected the Speech pathology department should be consulted. A formal "modified barium swallow" may ultimately be required to evaluate esophageal function. Please note that a modified barium swallow will not reliably detect anatomic abnormalities of the esophagus.