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

2012 ◽  
Vol 49 (4) ◽  
pp. 250-254 ◽  
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.

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

2015 ◽  
Vol 52 (1) ◽  
pp. 27-31 ◽  
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.

scholarly journals Response of the esophageal body to wet and dry swallows in Chagas' disease

2008 ◽  
Vol 45 (3) ◽  
pp. 195-198 ◽  
Author(s):  
Roberto Oliveira Dantas ◽  
Lilian Rose Otoboni Aprile
Keyword(s):  
Chagas Disease ◽  
Area Under The Curve ◽  
Normal Subjects ◽  
Upper Esophageal Sphincter ◽  
Control Group ◽  
Esophageal Body ◽  
Esophageal Sphincter ◽  
The Difference ◽  
Liquid Bolus ◽  
Esophageal Contraction

BACKGROUND: Wet swallows cause a greater esophageal contraction amplitude and duration than dry swallows. In Chagas' disease there is a reduction in amplitude of esophageal contraction but we do not know if the difference between wet and dry swallows is seen in the disease. AIM: To compare the esophageal contractions after wet and dry swallows in patients with Chagas' disease. METHODS: We measured the area under the curve (amplitude x duration) of the esophageal contractions in 30 patients with a diagnosis of esophageal involvement by Chagas' disease and 44 controls. We used the manometric method with continuous perfusion. The contractions were measured at 2, 7, 12 and 17 cm below the upper esophageal sphincter, after five swallows of a 5 mL bolus of water alternated with five dry swallows. RESULTS: In the control group wet swallows caused a higher area under the curve than dry swallows. There was no difference between wet and dry swallows in Chagas' disease patients, and there was no difference in wet and dry swallows in Chagas' disease patients compared with dry swallows of controls. At 12 and 17 cm from the upper esophageal sphincter the area under the curve after wet and dry swallows in Chagas' disease patients younger than 60 years (n = 15) was higher than in Chagas' disease patients older than 60 years (n = 15). CONCLUSION: We conclude that in normal subjects there is adaptation to the presence of a liquid bolus inside the esophageal body, which does not happen in patients with Chagas' disease.

scholarly journals SWALLOWING IN PATIENTS WITH LARYNGITIS

2018 ◽  
Vol 55 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Isabela MODA ◽  
Hilton Marcos Alves RICZ ◽  
Lilian Neto AGUIAR-RICZ ◽  
Roberto Oliveira DANTAS
Keyword(s):  
Transit Time ◽  
Random Sequence ◽  
Acid Reflux ◽  
Bolus Transit ◽  
Normal Volunteers ◽  
Esophageal Ph ◽  
Solid Bolus ◽  
Oral Preparation ◽  
Pharyngeal Transit ◽  
Liquid Bolus

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.

scholarly journals Effects of Meal Timing on Postprandial Glucose Metabolism and Blood Metabolites in Healthy Adults

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1763 ◽  
Author(s):  
Masaki Takahashi ◽  
Mamiho Ozaki ◽  
Moon-Il Kang ◽  
Hiroyuki Sasaki ◽  
Mayuko Fukazawa ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Tricarboxylic Acid Cycle ◽  
Area Under The Curve ◽  
Random Order ◽  
Postprandial Glucose ◽  
Healthy Adults ◽  
Blood Metabolites ◽  
Blood Collection ◽  
Meal Timing ◽  
The Difference

We examined the effects of meal timing on postprandial glucose metabolism, including the incretin response and metabolites in healthy adults. Nineteen healthy young men completed two trials involving blood collection in a fasting state and at 30, 60 and 120 min after meal provision in a random order: (1) morning (~0900 h) and (2) evening (~1700 h). The blood metabolome of eight participants was analyzed using capillary electrophoresis-mass spectrometry. Postprandial glucose concentrations at 120 min (p = 0.030) and glucose-dependent insulinotropic polypeptide concentrations (p = 0.005) at 60 min in the evening trials were higher than those in the morning trials. The incremental area under the curve values of five glycolysis, tricarboxylic acid cycle and nucleotide-related metabolites and 18 amino acid-related metabolites were higher in the morning trials than those in the evening trials (p < 0.05). Partial least-squares analysis revealed that the total metabolic change was higher in the morning. Our study demonstrates that a meal in the evening exacerbates the state of postprandial hyperglycemia in healthy adults. In addition, this study provides insight into the difference of incretion and blood metabolites between breakfast and dinner, indicating that the total metabolic responses tends to be higher in the morning.

scholarly journals Gender differences in proximal esophageal contractions

2009 ◽  
Vol 46 (4) ◽  
pp. 284-287 ◽  
Author(s):  
Roberto Oliveira Dantas ◽  
Leda Maria Tavares Alves ◽  
Rachel de Aguiar Cassiani
Keyword(s):  
Respiratory Diseases ◽  
Statistical Significance ◽  
Area Under The Curve ◽  
Upper Esophageal Sphincter ◽  
Time Interval ◽  
Men And Women ◽  
Manometric Method ◽  
Esophageal Sphincter ◽  
The Difference ◽  
Esophageal Contraction

CONTEXT: There are reports showing that gender has an influence on swallowing and on the contractions of the distal esophageal body. OBJECTIVE: In this investigation we studied the effect of gender on proximal esophageal contraction. METHODS: We studied 20 men (22-68 years old, median 39 years) and 44 women (18-61 years old, median 41 years) without symptoms and without gastrointestinal or respiratory diseases. We measured the time interval between the onset of pharyngeal contraction 1 cm proximal to the upper esophageal sphincter and the onset of the proximal esophageal contraction 5 cm from the pharyngeal recording. We also measured the amplitude, duration and area under the curve of the proximal esophageal contractions. The recording was performed by the manometric method with continuous perfusion. The contractions were recorded in duplicate after swallows of a 5 mL bolus of water. RESULTS: There were no differences between men and women in the interval between the onset of pharyngeal and of esophageal contractions or in the amplitude of esophageal contractions. The duration of contractions was longer in women (2.35 ± 0.60 s) than in men (2.07 ± 0.62 s) but the difference did not reach statistical significance (P = 0.087). The area under the curve of the esophageal contraction was higher in women (130.2 ± 55.2 mm Hg x s) than in men (97.4 ± 49.4 mm Hg x s, P = 0.026). CONCLUSION: We conclude that there is a difference between men and women in the proximal esophageal contractions in response to wet swallows, although this difference is of no clinical relevance.

374 VIDEO ESOPHAGOGRAM CORRELATES OF DYSPHAGIA IN PATIENTS WITH NORMAL LOWER ESOPHAGEAL SPHINCTER

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
D Razia ◽  
L Giulini ◽  
R Bremner ◽  
S Mittal
Keyword(s):  
Prone Position ◽  
Transit Time ◽  
Esophageal Wall ◽  
Bolus Transit ◽  
Esophageal Transit ◽  
Dysphagia Score ◽  
Esophageal Spasm ◽  
Number Of Patients ◽  
The Difference ◽  
Barium Esophagogram

Abstract   Dysphagia is a common foregut symptom. However, there is poor association between non-obstructive dysphagia and esophageal body peristaltic parameters in patients with normal lower esophageal sphincters (LES). The objective of this retrospective study was to study bolus transit patterns noted on barium esophagogram in patients experiencing dysphagia. Methods After IRB approval, we queried our esophageal database for patients with normal manometric LES. Jackhammer esophagus, esophageal spasm, previous foregut surgery, and unavailable foregut symptom questionnaires were exclusion criteria. Patients were grouped based on reported dysphagia: 0 = None; 1 = Mild; 2 = Moderate; 3 = Severe/very severe. All barium esophagograms were re-evaluated. Bolus esophageal transit time was studied with patients in both upright and prone positions, using live time stamps at bolus entry/exit. “Barium residue” was defined as persistent contrast on the esophageal wall after bolus exit. “Retrograde escape” referred to barium escaping proximally from the bolus into previously cleared esophagus. ANOVA and χ2 were used. Results In all, 150 patients met inclusion criteria. 76 (50.1%) were women. Mean age and body mass index were 58.4 ± 14.7 years and 22.9 ± 10.4 kg/m2, respectively. The number of patients in each dysphagia group (0, 1, 2, and 3) were 82(54.7%), 29(19.3%), 25(16.7%) and 14(9.3%), respectively. The difference in mean bolus transit time among dysphagia groups was statistically significant in prone-position swallows (39.3 ± 36.7, 75 ± 74.8, 98.8 ± 85 and 69.6 ± 43.7 seconds; p &lt; 0.001) but not in upright-position swallows (14.6 ± 22, 12.4 ± 8.1, 14.3 ± 8.8 and 12.6 ± 8.2 seconds; p = 0.929; Fig. 1). The prevalence of residual contrast and retrograde escape in prone swallows were comparable among patients reporting dysphagia (p = 0.444, p = 0.173). Conclusion Bolus transit time in prone-position barium swallows is simple to assess, and correlates with dysphagia reported by patients with normal lower esophageal sphincters. However, further studies with comprehensive dysphagia score are needed.

Effect of dry swallows and wet swallows of different volumes on esophageal peristalsis

1975 ◽  
Vol 38 (6) ◽  
pp. 1161-1164 ◽  
Author(s):  
J. B. Hollis ◽  
D. O. Castell
Keyword(s):  
Wave Speed ◽  
Normal Subjects ◽  
Esophageal Peristalsis ◽  
Esophageal Function ◽  
Contraction Amplitude ◽  
Primary Peristalsis ◽  
Afferent Information ◽  
Liquid Bolus ◽  
Esophageal Contraction ◽  
Contraction Wave

The effect of dry swallows and wet swallows of various volumes on esophageal function was studied in normal subjects. An intraesophageal transducer assembly was used to measure the dynamics of esophageal peristalsis. The strength of esophageal contraction (amplitude) following a 1-ml liquid bolus was similar to that following a dry swallow but was significantly less than that following a wet swallow of a larger volume. There was no difference in strength of esophageal squeeze following swallows ranging from 2 to 20 ml. In addition, a wet swallow was associated with slower wave speed, greater duration of the contraction wave, and later time of appearance of the peristaltic wave in the distal esophagus than a dry swallow. Futhermore, the incidence of peristalsis was greater with a wet swallow than a dry swallow. The results of our studies indicate that although the act of swallowing alone in man initiates peristalsis, afferent information contributes to the regulation of primary peristalsis.

scholarly journals EFFECT OF A BITTER BOLUS ON ORAL, PHARYNGEAL AND ESOPHAGEAL TRANSIT OF HEALTHY SUBJECTS

2013 ◽  
Vol 50 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Leda Maria Tavares ALVES ◽  
Marie SECAF ◽  
Roberto Oliveira DANTAS
Keyword(s):  
Bitter Taste ◽  
Random Sequence ◽  
Normal Subjects ◽  
Sweet Taste ◽  
Neurologic Diseases ◽  
Esophageal Transit ◽  
Solid Foods ◽  
Oral Behavior ◽  
Liquid Bolus ◽  
Asymptomatic Subjects

ContextDuring swallowing, boluses stimulate sensory receptors of the oral, pharyngeal, laryngeal, and esophageal regions. Sweet and tasteless foods are more acceptable for swallowing than bitter foods. A bitter bolus is unpleasant for most subjects. Our hypothesis was that the ingestion of a bitter bolus might alter the oral behavior, pharyngeal and esophageal transit when compared to a sweet bolus.ObjectiveTo evaluate whether the bitter taste of a liquid bolus causes alteration on oral, pharyngeal and/or esophageal transit in normal subjects in comparison with sweet bolus.’MethodScintigraphic evaluation of oral, pharyngeal and esophageal transit was performed in 43 asymptomatic subjects, 22 women and 21 men, ages 23-71 years, without problems with the ingestion of liquid and solid foods, and without digestive, cardiac or neurologic diseases. Each subject swallowed in random sequence and at room temperature 5 mL of a liquid bolus with bitter taste, prepared with 50 mL of water with 2 g of leaves of Peumus boldus, heated until boiling (boldus tea), and 5 mL of a liquid bolus with sweet taste, prepared with 50 mL of water with 3 g of sucrose, both labeled with 37 MBq of technetium phytate (Tc99m).ResultsThere was no difference between the bitter bolus and the sweet bolus in mouth, pharynx and esophageal transit and clearance duration and in the amount of residues.ConclusionA bitter bolus, considered an unpleasant bolus, does not alter the duration of oral, pharyngeal and esophageal phases of swallowing, when compared with a sweet bolus, considered a pleasant bolus.

Nasal Absorption of Growth Hormone in Normal Subjects: Studies with Four Different Formulations

1994 ◽  
Vol 28 (7-8) ◽  
pp. 845-848 ◽  
Author(s):  
Torben Laursen ◽  
Per Ovesen ◽  
Birgitte Grandjean ◽  
Sigrid Jensen ◽  
Jens Otto L. Jørgensen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Maximum Concentration ◽  
Relative Concentration ◽  
Elevated Serum ◽  
Area Under The Curve ◽  
Random Order ◽  
Normal Subjects ◽  
Nasal Symptom ◽  
Subcutaneous Injections ◽  
Gh Secretion

OBJECTIVE: Current growth hormone (GH) therapy with daily subcutaneous injections results in elevated serum concentrations of GH lasting for several hours, whereas physiologic GH secretion is characterized by a short-duration peak and low basal concentrations. A closer imitation of this pattern might be achieved by administering GH nasally. We studied the effect on the absorption of nasally administered human GH of increasing concentrations of the enhancer didecanoyl-L-α-phosphatidylcholine (DDPC). DESIGN: Four formulations of nasal GH containing the enhancer DDPC in the relative concentrations 0, 4,8, and 16% w/w were administered in random order. SETTING: Participants were admitted to the hospital during the four study periods. INTERVENTIONS: On four occasions the subjects received GH 6 IU (2 mg) in each nostril. Blood was sampled frequently for four hours. Anterior rhinoscopy was performed at 0 and 4 h. During the study the subjects completed a questionnaire to record nasal symptoms. PATIENTS: Sixteen healthy subjects were examined at 0800 h after an overnight fast. MAIN OUTCOME MEASURES: Bioavailability of a nasal preparation of human GH: area under the curve (AUC), the maximum concentration(Cmax), and the time to reach maximum concentration (tmax). Scores for each nasal symptom were recorded as were the total scores. RESULTS: AUC, Cmax, and tmax,. were not significantly affected by increasing the DDPC concentration from 0 to 4 percent or from 8 to 16 percent. AUC and Cmax, however, increased significantly when the concentration of DDPC was changed from 4 to 8 percent. Mean (±SD) AUC (μg·h/L) increased from 20.51 ± 10.53(4 percent)to 46.14 ± 34.59 (8 percent), (p<0.005). Mean (±SD) of Cmax (μg.L) increased from 11.11 ± 5.02 (4 percent) to 28.22 ± 20.85 (8 percent), (p=0.OO2). Mean (±SD) of tmax (min) was not significantly different on the four occasions(range 40.6 ± 36.4 to 61.0 ± 45.2 min, p=0.13). The symptom scores (range 17.56–21.5, maximum 360) were not significantly different (p=0.59). CONCLUSIONS: Increasing the relative concentration of the enhancer DDPC increases the absorption of nasally administered GH.

scholarly journals ESOPHAGEAL MOTILITY IN TROUBLESOME BELCHING

2013 ◽  
Vol 50 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Ana Cristina Viana da SILVA ◽  
Lilian Rose Otoboni APRILE ◽  
Roberto Oliveira DANTAS
Keyword(s):  
Solid State ◽  
Transit Time ◽  
Area Under The Curve ◽  
Bolus Transit ◽  
Esophageal Body ◽  
Esophageal Sphincter ◽  
Main Determinants ◽  
And Control ◽  
Rapid Expulsion ◽  
Esophageal Contraction

Context Supragastric belches are the main determinants of troublesome belching symptoms. In supragastric belches, air is rapidly brought into the esophagus and is immediately followed by a rapid expulsion before it has reached the stomach. Objective To evaluate the esophageal contraction and transit after wet swallows in patients with troublesome belching. Methods Esophageal contraction and transit were evaluated in 16 patients with troublesome belching and 15 controls. They were measured at 5, 10, 15, and 20 cm from the lower esophageal sphincter (LES) by a solid state manometric and impedance catheter. Each subject swallowed five 5 mL boluses of saline. Results The amplitude, duration and area under the curve of contractions were similar in patients with troublesome belching and control subjects. The total esophageal bolus transit time was 6.2 (1.8) s in patients with troublesome belching and 6.1 (2.3) s in controls (P = 0.55). The bolus presence time was longer in controls than in patients at 5 cm from the LES [controls: 6.0 (1.1) s, patients: 4.9 (1.2) s, P = 0.04], without differences at 10, 15 and 20 cm from the LES. The bolus head advanced time was longer in patients than controls from 20 cm to 15 cm [controls: 0.1 (0.1) s, patients: 0.7(0.8)s, P = 0.01] and from 15 cm to 10 cm [controls: 0.3 (0.1) s, patients: 1.6 (2.6) s, P = 0.01] of the LES, without difference from 10 cm to 5 cm [controls: 0.7 (0.3) s, patients: 1.0 (1.1) s, P = 0.37]. There was no difference in segment transit time. Conclusion There was no difference in esophageal contractions between patients with troublesome belching and controls. The swallowed bolus went slower into the proximal and middle esophageal body in patients than in control, but cross the distal esophageal body faster in patients than in controls.

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