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 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 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.

Dynamics of esophageal bolus transport in healthy subjects studied using multiple intraluminal impedancometry

1997 ◽  
Vol 273 (4) ◽  
pp. G958-G964 ◽  
Author(s):  
H. N. Nguyen ◽  
J. Silny ◽  
D. Albers ◽  
E. Roeb ◽  
C. Gartung ◽  
...  
Keyword(s):  
Temporal Resolution ◽  
Healthy Subjects ◽  
Upright Position ◽  
Bolus Transit ◽  
Test Conditions ◽  
Impedance Technique ◽  
Bolus Viscosity ◽  
Liquid Bolus ◽  
Bolus Propulsion ◽  
Different Parts

The dynamics of a bolus transport through the esophagus are largely unexplored. To study this physiological process, we applied multiple intraluminal impedancometry in 10 healthy subjects. Three different protocols were used: 1) liquid bolus administered with subject supine, 2) liquid bolus with subject upright, or 3) semisolid bolus with subject supine. Transit of different parts of a bolus (bolus head, body, and tail) was analyzed at different anatomic segments, namely the pharynx and the proximal, middle, and distal thirds of the esophagus. A characteristic pattern of bolus transport was seen in all subjects. Impedance changes related to air were observed preceding the bolus head. The bolus head propelled significantly faster than did the bolus body and tail. Pharyngeal bolus transit was significantly faster than esophageal bolus transit. Within the esophagus, bolus propulsion velocity gradually decreased. Bolus transport was significantly accelerated in the upright position and delayed with increase of bolus viscosity. In conclusion, the dynamics of a bolus transport from the pharynx into the stomach are complex. It varies within both different anatomic segments and different parts of the bolus and depends on bolus characteristics and test conditions. The spatial and temporal resolution of a bolus transport can be obtained by the impedance technique.

scholarly journals VIDEOFLUOROSCOPIC EVALUATION OF SWALLOWS IN ANOREXIA NERVOSA

2016 ◽  
Vol 53 (3) ◽  
pp. 136-140 ◽  
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.

Effect of lung volume and positional changes on pulmonary diffusing capacity and its components

1991 ◽  
Vol 71 (4) ◽  
pp. 1477-1488 ◽  
Author(s):  
H. Stam ◽  
F. J. Kreuzer ◽  
A. Versprille
Keyword(s):  
Lung Volume ◽  
Supine Position ◽  
Body Position ◽  
Membrane Conductance ◽  
Normal Subjects ◽  
Negative Slope ◽  
Sitting Position ◽  
Diffusing Capacity ◽  
Alveolar Volume ◽  
Residual Capacity

Normal subjects have a larger diffusing capacity normalized per liter alveolar volume (DL/VA) in the supine than in the sitting position. Body position changes total lung diffusing capacity (DL), DL/VA, membrane conductance (Dm), and effective pulmonary capillary blood volume (Qc) as a function of alveolar volume (VA). These functions were studied in 37 healthy volunteers. DL/VA vs. VA yields a linear relationship in sitting as well as in supine position. Both have a negative slope but usually do not run parallel. In normal subjects up to 50 yr old DL/VA and DL increased significantly when subjects moved from a sitting to a supine posture at volumes between 50 and 100% of total lung capacity (TLC). In subjects greater than 50 yr old the responses of DL/VA and DL to change in body position were not significant at TLC. Functional residual capacity (FRC) decreases and DL/VA increases in all normal subjects when they change position from sitting to supine. When DL/VA increases more than predicted from the DL/VA vs. VA relationship in a sitting position, we may infer an increase in effective Qc in the supine position. In 56% of the volunteers, supine DL was smaller than sitting DL despite a higher DL/VA at FRC in the supine position because of the relatively larger decrease in FRC. When the positional response at TLC is studied, an estimation obtained accidentally at a volume lower than TLC may influence results. Above 80% of TLC, Dm decreased significantly from sitting to supine. Below this lung volume the decrease was not significant. The relationship between Qc and VA was best described by a second-order polynomial characterized by a maximum Qc at a VA greater than 60% of TLC. Qc was significantly higher in the supine position than in the sitting position, but the difference became smaller with increasing age. In observing the sitting and supine positions, we saw a decrease in maximum Qc normalized per square meter of body surface area with age.

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.

Effect of pharyngeal water stimulation on esophageal peristalsis and bolus transport

1997 ◽  
Vol 272 (2) ◽  
pp. G265-G271 ◽  
Author(s):  
E. Bardan ◽  
P. Xie ◽  
J. Ren ◽  
K. Dua ◽  
R. Shaker
Keyword(s):  
Clinical Practice ◽  
Healthy Volunteers ◽  
Supine Position ◽  
Esophageal Manometry ◽  
Water Injection ◽  
Esophageal Peristalsis ◽  
Bolus Transit ◽  
Sensory Stimuli ◽  
Threshold Volume ◽  
Liquid Bolus

Sensory stimuli originating from the pharynx inhibit esophageal peristalsis induced by a dry swallow. Our aims were to determine the effect of these stimuli on esophageal bolus transport and esophageal peristalsis induced by swallowing different volumes of liquid and semisolid boluses. We studied nine healthy volunteers age 35 +/- 4 yr in the supine position by intraluminal esophageal manometry as well as concurrent videofluoroscopy and manometry. In all subjects progression of peristalsis induced by swallowing of different volumes of water and mashed potato boluses was inhibited at all sites by pharyngeal water injection. Threshold volume for inhibition of the peristalsis induced by swallows of 5 and 10 ml of water was similar but significantly higher compared with dry swallows (P < 0.05). Pharyngeal water injection invariably halted transit of the barium boluses through the esophagus. Sensory impulses originating from the pharynx 1) inhibit esophageal bolus transit and 2) are capable of overcoming the facilitating effect of a liquid bolus on the swallowing apparatus. This phenomenon may explain the mechanism of some of the failed esophageal peristalsis observed in clinical practice.

scholarly journals Reproducibility and agreement between three positions for handgrip assessment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Olga-Cecilia Vargas-Pinilla ◽  
Eliana-Isabel Rodríguez-Grande
Keyword(s):  
Supine Position ◽  
Cross Sectional Study ◽  
Sitting Position ◽  
Average Difference ◽  
Cross Sectional ◽  
Hand Grip ◽  
Standardization Process ◽  
The One ◽  
Level Of Agreement ◽  
Apparently Healthy

AbstractThe protocol established for taking hand grip dynamometry measurements determines that the patient must be in a sitting position. This protocol cannot be applied due to the patient’s conditions in some cases, such as abdominal surgery, musculoskeletal spine or hip injuries. The purpose was to determine the reproducibility and level of agreement between the Handgrip dynamometry in supine position with the elbow flexed or extended, and the one measured in the sitting position, the design was a descriptive cross-sectional study. The population were young apparently healthy between 18 and 30 years of age (N = 201). Handgrip measurement was performed on both upper limbs in a sitting position with a flexed elbow, a supine position with a flexed elbow, and supine position with the elbow extended. Reproducibility was nearly perfect in all positions (ICC 0.95–0.97). Regarding the level of agreement for the comparison between sitting and supine positions with a flexed elbow, an average difference of − 0.406. For supine position with an extended elbow and supine position with a flexed elbow, the average difference was − 1.479. Considering the results, clinicians or researchers can choose any of the positions evaluated herein and obtain reliable results as long as the standardization process is followed.

Effects of body position change on thoracoabdominal motion

1978 ◽  
Vol 45 (4) ◽  
pp. 581-589 ◽  
Author(s):  
V. P. Vellody ◽  
M. Nassery ◽  
W. S. Druz ◽  
J. T. Sharp
Keyword(s):  
Supine Position ◽  
Muscle Force ◽  
Body Position ◽  
Tidal Breathing ◽  
Position Change ◽  
Rib Cage ◽  
Inspiratory Muscles ◽  
Residual Capacity ◽  
Lateral Decubitus ◽  
Local Compliance

With a linearized respiratory magnetometer, measurements of anteroposterior and lateral diameters of both the rib cage and the abdomen were made at functional residual capacity and continuously during tidal breathing. Twenty-five subjects with normal respiratory systems were studied in the sitting, supine, lateral decubitus, and prone body positions. When subjects changed from sitting to supine position anteroposterior diameters of both rib cage and abdomen decreased while their lateral diameters increased. Both anteroposterior and lateral tidal excursions of the rib cage decreased; those of the abdomen increased. When subjects turned from supine to lateral decubitus position both anteroposterior diameters increased and the lateral diameters decreased. This was associated with an increase in both lateral excursions and a decrease in the abdominal anteroposterior excursions. Diameters and tidal excursions in the prone position resembled those in the supine position. Diameter changes could be explained by gravitational effects. Differences in tidal excursions accompanying body position change were probably related to 1) differences in the distribution of respiratory muscle force, 2) differences in the activity or mechanical advantage of various inspiratory muscles, and 3) local compliance changes in parts of the rib cage and abdomen.

scholarly journals Upright versus supine MRI: effects of body position on craniocervical CSF flow

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Marco Muccio ◽  
David Chu ◽  
Lawrence Minkoff ◽  
Neeraj Kulkarni ◽  
Brianna Damadian ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Supine Position ◽  
Cardiac Cycle ◽  
Body Position ◽  
Csf Flow ◽  
Position Change ◽  
Phase Duration ◽  
Brain Functions ◽  
Systolic Phase ◽  
The Brain

Abstract Background Cerebrospinal fluid (CSF) circulation between the brain and spinal canal, as part of the glymphatic system, provides homeostatic support to brain functions and waste clearance. Recently, it has been observed that CSF flow is strongly driven by cardiovascular brain pulsation, and affected by body orientation. The advancement of MRI has allowed for non-invasive examination of the CSF hydrodynamic properties. However, very few studies have addressed their relationship with body position (e.g., upright versus supine). It is important to understand how CSF hydrodynamics are altered by body position change in a single cardiac phase and how cumulative long hours staying in either upright or supine position can affect craniocervical CSF flow. Methods In this study, we investigate the changes in CSF flow at the craniocervical region with flow-sensitive MRI when subjects are moved from upright to supine position. 30 healthy volunteers were imaged in upright and supine positions using an upright MRI. The cranio-caudal and caudo-cranial CSF flow, velocity and stroke volume were measured at the C2 spinal level over one cardiac cycle using phase contrast MRI. Statistical analysis was performed to identify differences in CSF flow properties between the two positions. Results CSF stroke volume per cardiac cycle, representing CSF volume oscillating in and out of the cranium, was ~ 57.6% greater in supine (p < 0.0001), due to a ~ 83.8% increase in caudo-cranial CSF peak velocity during diastole (p < 0.0001) and extended systolic phase duration when moving from upright (0.25 ± 0.05 s) to supine (0.34 ± 0.08 s; p < 0.0001). Extrapolation to a 24 h timeframe showed significantly larger total CSF volume exchanged at C2 with 10 h spent supine versus only 5 h (p < 0.0001). Conclusions In summary, body position has significant effects on CSF flow in and out of the cranium, with more CSF oscillating in supine compared to upright position. Such difference was driven by an increased caudo-cranial diastolic CSF velocity and an increased systolic phase duration when moving from upright to supine position. Extrapolation to a 24 h timeframe suggests that more time spent in supine position increases total amount of CSF exchange, which may play a beneficial role in waste clearance in the brain.

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