scholarly journals Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3879
Author(s):  
Paul Muhle ◽  
Karen Konert ◽  
Sonja Suntrup-Krueger ◽  
Inga Claus ◽  
Bendix Labeit ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Neurological Disease ◽  
Oropharyngeal Dysphagia ◽  
Upper Gastrointestinal Tract ◽  
Swallowing Function ◽  
Neurological Condition ◽  
Gastrointestinal Dysmotility ◽  
Single Center Study ◽  
The Impact ◽  
Upper Gastrointestinal

Patients in the neurological ICU are at risk of suffering from disorders of the upper gastrointestinal tract. Oropharyngeal dysphagia (OD) can be caused by the underlying neurological disease and/or ICU treatment itself. The latter was also identified as a risk factor for gastrointestinal dysmotility. However, its association with OD and the impact of the neurological condition is unclear. Here, we investigated a possible link between OD and gastric residual volume (GRV) in patients in the neurological ICU. In this retrospective single-center study, patients with an episode of mechanical ventilation (MV) admitted to the neurological ICU due to an acute neurological disease or acute deterioration of a chronic neurological condition from 2011–2017 were included. The patients were submitted to an endoscopic swallowing evaluation within 72 h of the completion of MV. Their GRV was assessed daily. Patients with ≥1 d of GRV ≥500 mL were compared to all the other patients. Regression analysis was performed to identify the predictors of GRV ≥500 mL/d. With respect to GRV, the groups were compared depending on their FEES scores (0–3). A total of 976 patients were included in this study. A total of 35% demonstrated a GRV of ≥500 mL/d at least once. The significant predictors of relevant GRV were age, male gender, infratentorial or hemorrhagic stroke, prolonged MV and poor swallowing function. The patients with the poorest swallowing function presented a GRV of ≥500 mL/d significantly more often than the patients who scored the best. Conclusions: Our findings indicate an association between dysphagia severity and delayed gastric emptying in critically ill neurologic patients. This may partly be due to lesions in the swallowing and gastric network.

W2053 The Impact of Using Different Standardized Meals in the Assessment of Motility of Upper Gastrointestinal Tract

2009 ◽  
Vol 136 (5) ◽  
pp. A-781 ◽  
Author(s):  
Maria C. Bucur ◽  
Whitney Michalek ◽  
Richard McCallum ◽  
Kenneth L. Koch ◽  
Michael D. Sitrin ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
The Impact ◽  
Upper Gastrointestinal

scholarly journals The Impact of Novel Anticoagulants on the Upper Gastrointestinal Tract Mucosa

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 363
Author(s):  
Lubomir Mihalkanin ◽  
Branislav Stancak
Keyword(s):  
Gastrointestinal Tract ◽  
Protective Factor ◽  
Bleeding Risk ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Tract ◽  
Bleeding Detection ◽  
Increased Risk ◽  
Clinically Significant ◽  
The Impact ◽  
Upper Gastrointestinal

Background and objectives: Although treatment with novel oral non-vitamin K antagonist 3anticoagulants (NOACs) is associated with an overall decrease in hemorrhagic complications compared to warfarin, the incidence of gastrointestinal bleeding remains contradictory. Materials and Methods: After the exclusion of patients with pre-existing pathological lesions in the upper gastrointestinal tract (GIT) on esophageal-gastroduodenoscopy (EGD) at entry, a cohort of 80 patients (mean age of 74.8 ± 2.0 years) was randomly divided into four equivalent groups, treated with dabigatran, rivaroxaban, apixaban, or warfarin. Patients were prospectively followed up for three months of treatment, with a focus on anamnestic and endoscopic signs of bleeding. In addition, bleeding risk factors were evaluated. Results: In none of the patients treated with warfarin or NOACs was any serious or clinically significant bleeding recorded within the follow-up period. The incidence of clinical bleeding and endoscopically detected bleeding in the upper GT after three months of treatment was not statistically different among groups (χ2 = 2.8458; p = 0.41608). The presence of Helicobacter pylori (HP) was a risk factor for upper GIT bleeding (p < 0.05), while the use of proton pump inhibitors (PPIs) was a protective factor (p = 0.206; Spearman’s correlation coefficient = 0.205). We did not record any post-biopsy continued bleeding. Conclusions: No significant GIT bleeding was found in any of the treatment groups, so we consider it beneficial to perform routine EGD before the initiation of any anticoagulant therapy in patients with an increased risk of upper GIT bleeding. Detection and eradication of HP as well as preventive PPI treatment may mitigate the occurrence of endoscopic bleeding. Endoscopic biopsy during the NOAC treatment is safe.

The impact of meals on a probiotic during transit through a model of the human upper gastrointestinal tract

2011 ◽  
Vol 2 (4) ◽  
pp. 295-303 ◽  
Author(s):  
T. Tompkins ◽  
I. Mainville ◽  
Y. Arcand
Keyword(s):  
Gastrointestinal Tract ◽  
Milk Fat ◽  
Bifidobacterium Longum ◽  
Gastrointestinal Transit ◽  
Buffering Capacity ◽  
Lactobacillus Helveticus ◽  
Upper Gastrointestinal Tract ◽  
The Impact ◽  
Upper Gastrointestinal

Commercial literature on various probiotic products suggests that they can be taken before meals, during meals or after meals or even without meals. This has led to serious confusion for the industry and the consumer. The objective of our study was to examine the impact of the time of administration with respect to mealtime and the impact of the buffering capacity of the food on the survival of probiotic microbes during gastrointestinal transit. We used an in vitro Digestive System (IViDiS) model of the upper gastrointestinal tract to examine the survival of a commercial multi-strain probiotic, ProtecFlor®. This product, in a capsule form, contains four different microbes: two lactobacilli (Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011), Bifidobacterium longum R0175 and Saccharomyces cerevisiae boulardii. Enumeration during and after transit of the stomach and duodenal models showed that survival of all the bacteria in the product was best when given with a meal or 30 minutes before a meal (cooked oatmeal with milk). Probiotics given 30 minutes after the meal did not survive in high numbers. Survival in milk with 1% milk fat and oatmeal-milk gruel were significantly better than apple juice or spring water. S. boulardii was not affected by time of meal or the buffering capacity of the meal. The protein content of the meal was probably not as important for the survival of the bacteria as the fat content. We conclude that ideally, non-enteric coated bacterial probiotic products should be taken with or just prior to a meal containing some fats.

scholarly journals The impact of age and sex on the occurrence of pathology in the wall of the upper gastrointestinal tract

2017 ◽  
Vol 3 ◽  
pp. 192-198
Author(s):  
Przemysław Dyrla ◽  
Jerzy Gil ◽  
Stanisław Niemczyk ◽  
Marek Saracyn ◽  
Krzysztof Kosik ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
The Impact ◽  
Upper Gastrointestinal ◽  
Age And Sex

scholarly journals P-BN12 Impact of covid-19 on ugi (upper gastrointestinal) tract stenting and dilatation services- prioritise, keep scoping and training

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Chia Chuin Yau ◽  
Shiran Esmaily ◽  
Deepak Dwarakanath ◽  
John Hancock ◽  
Vikramjit Mitra
Keyword(s):  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
British Society ◽  
Entire Study ◽  
Endoscopic Procedures ◽  
Peptic Stricture ◽  
Oesophageal Dilatation ◽  
The Uk ◽  
The Impact ◽  
Upper Gastrointestinal

Abstract Background The COVID-19 pandemic profoundly affected endoscopy services including therapeutic gastroscopy across the UK. The BSG (British Society of Gastroenterology) issued guidance for managing endoscopy services safely throughout this period. At the beginning of the pandemic in March 2020, a symptom-based questionnaire was used to screen patients for COVID-19 prior to their endoscopic procedures in our hospital (COVID-19 swabs were only carried out if patients presented with COVID-19 symptoms). From 18 May 2020 onwards, in addition to the above approach, all patients attending endoscopic procedures underwent a SARS-CoV-2 nasopharyngeal swab 1-3 days prior to the procedure. We describe our experience of UGI stenting and dilatation during the initial wave of COVID-19 pandemic in the UK.  Aims To assess the impact of COVID-19 pandemic on technical and clinical success of luminal dilatation and stenting in the UGI tract and ascertain the risk of procedure related complications. Methods A retrospective audit of a prospectively maintained endoscopy database was carried out between 18th March and 31st July. All patients were followed for 30 days. Full PPE were used. Results 42 procedures [31 were oesophageal dilatation (21 peptic stricture, 9 radiotherapy stricture, 1 achalasia), 8 oesophageal stent insertion (6 for primary oesophageal cancer, 1 metastatic cancer and 1 secondary to external compression from lung cancer) and 3 pyloric dilatation all benign] were carried out-mean age 65 years, 64.3% males, 81% of procedures were carried out as outpatients. All procedures were performed under fluoroscopy. 41/42(97.6%) patients had a confirmed histology prior to their procedure – one patient who underwent oesophageal dilatation had a peptic stricture on endoscopy (no biopsy or imaging). 39/42(92.9%) patients had undergone CT scan and/or barium swallow prior to their first procedure. All procedures were technically and clinically successful (100%).There were no procedure related complications or mortality. There were no COVID positive swabs in the 30-day post procedure period during the entire study period. Trainees were present in 21/42 (50%) of the procedures. None of the endoscopists who were involved with these procedures were diagnosed with COVID-19 during this period. One of the nursing staff, who regularly assisted in the fluoroscopy room, was involved in a non-fluoroscopic endoscopic procedure in a COVID-19 patient (not known at the time of the procedure) and subsequently tested positive.  Conclusions Our study confirms that a high quality stenting and dilatation service of the upper gastrointestinal tract together with specialist registrar training can be delivered safely and effectively during the COVID-19 pandemic in appropriately prioritised symptomatic patients. 

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