SWALLOWING IN PATIENTS WITH LARYNGITIS

ABSTRACT BACKGROUND: Dysphagia is described as a complaint in 32% of patients with laryngitis. OBJECTIVE: The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. METHODS: Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. RESULTS: The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. CONCLUSION: A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

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VIDEOFLUOROSCOPIC EVALUATION OF SWALLOWS IN ANOREXIA NERVOSA

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032016000300003 ◽

2016 ◽

Vol 53 (3) ◽

pp. 136-140 ◽

Cited By ~ 1

Author(s):

Carla Manfredi SANTOS ◽

Rachel Aguiar CASSIANI ◽

Roberto Oliveira DANTAS

Keyword(s):

Anorexia Nervosa ◽

Healthy Volunteers ◽

Random Sequence ◽

Bolus Transit ◽

Hyoid Movement ◽

The Mean ◽

Pharyngeal Transit ◽

Pharyngeal Swallowing ◽

Liquid Bolus ◽

Masticatory Process

ABSTRACT Background There are some studies in the literature about the feeding behavior and masticatory process in patients with feeding disorders; however, it is not very well known if there are alterations in oral-pharyngeal swallowing dynamics in subjects with anorexia nervosa. Objective To evaluate the oral and pharyngeal bolus transit in patients with anorexia nervosa. Methods The study was conducted with 8 individuals clinically diagnosed and in treatment for restricting-type anorexia nervosa (seven women and one man), and 14 healthy individuals with no digestive or neurological symptoms (10 women, 4 men). Swallows were evaluated by videofluoroscopy with three swallows of 5 mL liquid bolus and three swallows of 5 mL paste bolus consistency, given in a random sequence. The participants were asked after each swallow about the sensation of the bolus passage. Results In the analysis of oral-pharyngeal transit duration, the mean duration of pharyngeal transit with paste bolus in patients with anorexia was shorter than in healthy volunteers (P=0.02). In the duration of movement of the hyoid bone, longer movement was observed in anorexia than in healthy volunteers with liquid bolus (P=0.01). With liquid bolus, five (62.5%) patients and one (7.1%) control had sensation of the bolus passage (P<0.05). Conclusion There seems to be no important alterations of swallowing in subjects with anorexia nervosa, although the results suggest that pharyngeal transit has shorter duration than that seen in healthy volunteers and the hyoid movement duration is longer in patients than in healthy volunteers. Fast pharyngeal transit may be the cause of bolus transit perception in patients with anorexia nervosa.

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EFFECT OF SWALLOWED BOLUS VISCOSITY AND BODY POSITION ON ESOPHAGEAL TRANSIT, CONTRACTION AND PERCEPTION OF TRANSIT

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000100007 ◽

2015 ◽

Vol 52 (1) ◽

pp. 27-31 ◽

Cited By ~ 8

Author(s):

Juciléia DALMAZO ◽

Lilian Rose Otoboni APRILE ◽

Roberto Oliveira DANTAS

Keyword(s):

Supine Position ◽

Body Position ◽

Random Sequence ◽

Sitting Position ◽

Bolus Transit ◽

Esophageal Transit ◽

Asymptomatic Volunteers ◽

Bolus Viscosity ◽

Liquid Bolus ◽

Esophageal Contraction

Background The esophagus has a different response in relation to the characteristics of a swallowed bolus. Bolus viscosity and body position may affect esophageal contraction and transit. Objectives To investigate the effect of bolus viscosity and body position on esophageal contraction, transit and perception. Methods Esophageal contraction, transit and perception of transit were evaluated in 26 asymptomatic volunteers, 13 men and 13 women aged 18-60 years, mean: 33.6 (12.2) years. Esophageal contraction (manometry) and transit (impedance) were measured with a solid state catheter with sensors located 5, 10, 15, and 20 cm from the lower esophageal sphincter. Each volunteer swallowed in duplicate and in random sequence a 5 mL low viscous (LV) liquid bolus of an isotonic drink with pH 3.3, and a 5 mL high viscous (HV) paste bolus, which was prepared with 7.5 g of instant food thickener diluted in 50 mL of water (pH: 6.4). Results Total bolus transit time, in the sitting position, was longer with the HV bolus than with the LV bolus. Esophageal transit was longer in the supine position than in the sitting position. Bolus head advance time was longer with the HV bolus than with the LV bolus in both positions. Contraction esophageal amplitude was higher in the supine position than in the sitting position. The perception of bolus transit was more frequent with the HV bolus than with the LV bolus, without differences related to position. Conclusions The viscosity of the swallowed bolus and body position during swallows has an influence on esophageal contractions, transit and perception of transit.

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Influence of aging on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1994.266.6.g972 ◽

1994 ◽

Vol 266 (6) ◽

pp. G972-G977 ◽

Cited By ~ 13

Author(s):

I. J. Cook ◽

M. D. Weltman ◽

K. Wallace ◽

D. W. Shaw ◽

E. McKay ◽

...

Keyword(s):

Transit Time ◽

Exposure Time ◽

Normal Aging ◽

Clearance Time ◽

Time Activity ◽

Bolus Transit ◽

Transit Times ◽

Scintigraphic Study ◽

Pharyngeal Transit ◽

Pharyngeal Clearance

The aim of the study was to determine the influence of normal aging on regional transit and the efficiency of bolus clearance during the oral and pharyngeal phases of swallowing. We compared scintigraphically derived oral-pharyngeal transit times and isotope clearance during swallowing in 21 healthy aged volunteers (mean age 68 +/- 8 yr) and 9 young controls (mean age 28 +/- 7.5 yr). Subjects swallowed 5- and 10-ml water boluses mixed with 30 MBq 99mtechnetium tin colloid. Oral and pharyngeal transit times, pharyngeal clearance time, and postswallow residual counts in each region were derived from time-activity curves. Pharyngeal residual counts were significantly greater in the aged than in controls (P = 0.0008), but age did not influence oral residual. Aging significantly prolonged oral transit time (P = 0.02), pharyngeal transit time (P = 0.0004), and pharyngeal clearance time (P = 0.0001). We conclude that normal impairs the efficiency of pharyngeal clearance during swallowing, prolongs scintigraphic measures of oral-pharyngeal transit, and increases the exposure time of the glottis to the swallowed bolus.

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Influence of Body Height on Oral and Pharyngeal Transit Time of a Liquid Bolus in Healthy Volunteers

Gastroenterology Research ◽

10.14740/gr1063w ◽

2018 ◽

Vol 11 (6) ◽

pp. 411-415

Author(s):

Marcia R.K. Bernardi Regueiro ◽

Luana Casari Parreira ◽

Weslania Viviane Nascimento ◽

Roberto Oliveira Dantas

Keyword(s):

Healthy Volunteers ◽

Transit Time ◽

Body Height ◽

Pharyngeal Transit ◽

Liquid Bolus

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The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032010000100004 ◽

2010 ◽

Vol 47 (1) ◽

pp. 18-21 ◽

Cited By ~ 34

Author(s):

Paula Cristina Cola ◽

Ana Rita Gatto ◽

Roberta Gonçalves da Silva ◽

André Augusto Spadotto ◽

Arthur Oscar Schelp ◽

...

Keyword(s):

Transit Time ◽

Oropharyngeal Dysphagia ◽

Cold Temperature ◽

Bolus Transit ◽

Sour Taste ◽

Positive Effects ◽

Transit Times ◽

Cold Food ◽

Pharyngeal Transit ◽

Dysphagic Patients

CONTEXT: The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified. OBJECTIVE: To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. METHODS: Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years) with ictus varying from 1 to 30 days (median of 6 days). To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour), one at a time, room temperature (22ºC) and cold (8ºC) were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. RESULTS: The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion - Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.

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The Effect of Bolus Taste on Oral and Pharyngeal Transit of Patients with Stroke

Revista Neurociências ◽

10.34024/rnc.2014.v22.8114 ◽

2014 ◽

Vol 22 (1) ◽

pp. 17-21

Author(s):

Leda Maria Tavares Alves ◽

Soraia Ramos Cabette Fabio ◽

Roberto Oliveira Dantas

Keyword(s):

Random Sequence ◽

Normal Subjects ◽

Control Group ◽

Control Subjects ◽

Pharyngeal Transit ◽

Liquid Bolus

Objective. To evaluate the effect of different bolus flavors in oral and pharyngeal transit duration of patients with stroke and normal volunteers. Method. The investigation had the participation of 36 patients (44-82 years, mean age: 63 years) with occurrence of stroke from 1 month to 84 months (median: 5.5 months) and 30 normal subjects (33-85 years, mean age: 59 years) who comprised the control group. The scintigraphic method was used to evaluate the oral and pharyngeal transit. Each subject swallowed in random sequence 5 mL of a liquid bolus of bitter, sour, sweet, and neutral taste, all labeled with 37 MBq of 99mTechnetium coupled with phytate. Results. Oral transit was longer in patients with stroke than in the control subjects for the sweet, bitter and sour tastes. Pharyngeal transit and clearance was longer in patients with stroke for the sweet and bitter tastes. In both groups there were no differences between neutral, sweet, sour or bitter tastes. Conclusion. Bolus tastes evaluated did not change oral and pharyngeal transit in normal subjects and patients with stroke.

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Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032012000400004 ◽

2012 ◽

Vol 49 (4) ◽

pp. 250-254 ◽

Cited By ~ 9

Author(s):

Juciléia Dalmazo ◽

Lilian Rose Otoboni Aprile ◽

Roberto Oliveira Dantas

Keyword(s):

Area Under The Curve ◽

Random Order ◽

Normal Subjects ◽

Bolus Transit ◽

Esophageal Transit ◽

Solid Bolus ◽

Asymptomatic Volunteers ◽

The Difference ◽

Liquid Bolus ◽

Esophageal Contraction

CONTEXT: Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. OBJECTIVES: To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. METHODS: The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink) and solid (macaroni) boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance. RESULTS: Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12) than in swallows with perception (n = 10). The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. CONCLUSION: The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

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The Importance of Extensional Rheology in Bolus Control during Swallowing

Scientific Reports ◽

10.1038/s41598-019-52269-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 4

Author(s):

Enrico Karsten Hadde ◽

Julie Ann Yvette Cichero ◽

Shaofeng Zhao ◽

Wei Chen ◽

Jianshe Chen

Keyword(s):

Transit Time ◽

Flow Behavior ◽

Upper Esophageal Sphincter ◽

Lateral View ◽

Extensional Viscosity ◽

Two Samples ◽

Swallowing Difficulty ◽

Ues Opening ◽

Pharyngeal Transit ◽

Liquid Bolus

Abstract Thickened fluids are commonly used in the medical management of individuals who suffer swallowing difficulty (known as dysphagia). Previous studies have shown that the rheological properties of a liquid affect the flow behavior of the bolus in swallowing, such as pharyngeal transit time. While there is no doubt that shear rheology is a highly important factor for bolus flow, it is suspected that extensional properties of a liquid bolus also plays an important role in swallowing, due to elongation of the bolus as it flows through the oropharynx. Our aim in this work was to observe the effect of extensional viscosity on pharyngeal transit time and elongation of the bolus during swallowing. Eight samples of thickened liquid barium that were shear-controlled, but varied in extensional viscosity and two samples that were extensional-controlled, but varied in shear viscosity were swallowed by eight healthy individuals. Data were collected under lateral view of videofluoroscopy swallow study (VFSS); measures of pharyngeal transit time and the ratio of the length to the width of the bolus on the frame of Upper Esophageal Sphincter (UES) opening were taken from the VFSS recordings. It was observed that the pharyngeal transit time generally increases when the fluids are thickened to higher IDDSI consistency. Additionally, higher extensional viscosity fluids reduced the elongation of the bolus during swallowing, thus potentially reducing the risk of post-swallow residue due to bolus breakage. This study confirmed the relevance of the extensional viscosity of the bolus in swallowing.

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