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Acoustic monitoring of swallow frequency has become important as the frequency of spontaneous swallowing can be an index for dysphagia and related complications. In addition, it can be employed as an objective quantification of ingestive behavior. Commonly, swallowing complications are manually detected using videofluoroscopy recordings, which require expensive equipment and exposure to radiation. In this study, a noninvasive automated technique is proposed that uses breath and swallowing recordings obtained via a microphone located over the laryngopharynx. Nonlinear diffusion filters were used in which a scale-space decomposition of recorded sound at different levels extract swallows from breath sounds and artifacts. This technique was compared to manual detection of swallows using acoustic signals on a sample of 34 subjects with Parkinson's disease. A speech language pathologist identified five subjects who showed aspiration during the videofluoroscopic swallowing study. The proposed automated method identified swallows with a sensitivity of 86.67 %, a specificity of 77.50 %, and an accuracy of 82.35 %. These results indicate the validity of automated acoustic recognition of swallowing as a fast and efficient approach to objectively estimate spontaneous swallow frequency.

Background/Aims: Chronic constipation is a common gastrointestinal disorder diagnosed using Rome III criteria. Defecography is a radiographic method used to identify anatomic abnormalities of anorectum. The present study aimed to evaluate the defecographic findings in patients with severe idiopathic chronic constipation. Methods: One hundred patients, who complained of severe idiopathic chronic constipation with abnormal balloon expulsion test, underwent defecography after injection of barium. An analysis of radiographs was performed by an expert radiologist for the diagnosis of descending perineum syndrome, rectocele, enterocele, rectal ulcer, rectal prolapse, fecal residue of post defecation, and etc. Then, they were compared between the two sexes. Results: Normal defecography was only observed in two participants. Descending perineum syndrome was the most common abnormality (73.3%). The results showed that rectocele (80.8%) and descending perineum syndrome (69.2%) were most frequent in women. In males, descending perineum syndrome and rectal prolapse were more prevalent (87% and 43.5%, respectively). Compared with men, rectocele and rectal ulcer were more frequently observed in women (p<0.001, and p=0.04, respectively), while men were more affected by descending perineum syndrome (p=0.04). In total, women had a greater incidence of abnormal defecographic findings compared with men (p=0.02). Conclusions: Defecography can be performed to detect anatomic abnormalities in patients with severe idiopathic chronic constipation and abnormal balloon expulsion test. This technique can assist physicians in making the most suitable decision for surgical procedure. (Korean J Gastroenterol 2017;70:39-43)

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Introduction: Functional constipation is one of the most common gastrointestinal symptoms which could affect patients’ quality of life. The colonic transit time test could be used for determining functional constipation subtypes. The aim of our study was to determine the abnormalities of the subtypes of functional constipation using CTT. Methods and Materials: This cross-sectional study was performed on 85 patients in 2011 in Shariaaty Hospital, Isfahan. All the patients received 60 radio-opaque markers, and they underwent radiological evaluation 5 days afterwards. Functional constipation was determined according to the distribution of the markers in the colon. Result: The samples consisted of 24 males and 61 females at a mean age of 42.7 ± 16.28 years. The colonic transit time results showed that 71 patients had normal transit time, 6 had a composite type, 5 had slow transit, and 3 had pelvic delay. There was no significant difference between sex and colon transit time types (P value =0.32). The mean colon transit time in our study was 51.8 ± 16.3 hours. Conclusion: Functional constipation patients should undergo CTT, especially those who use maneuvers for defecation and those who need more time for defecation.[GMJ. 2012;1(2):48-52]