Water Ingestion Dynamics in Patients With Achalasia: Influence of Sex and Age

Dantas, Roberto Oliveira; Cassiani, Rachel Aguiar; Santos, Carla Manfredi dos; Alves, Leda Maria Tavares

doi:10.1590/s0004-2803.201800000-43

Cited by 4 publications

(6 citation statements)

References 32 publications

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“…For example, lower esophageal motility in healthy women may predispose them to achalasia and dysphagia, while men are more likely to develop aortic aneurysms due to increased MMP9 expression in aortic smooth muscle cells. 19,20 Our findings may reflect an inherent sex difference, but further studies are needed as previously similar resting pressures have been reported in asymptomatic women and men. 17 Not surprisingly, our cohort demonstrated lower squeeze pressures than reported for asymptomatic people and had extremely low resting pressures.…”

Section: Discussionsupporting

confidence: 66%

“…Although smooth muscles were traditionally thought to have similar strength and function between women and men, emerging data suggest that sex differences in smooth muscle function account for sexual dimorphism in disease predilection. For example, lower esophageal motility in healthy women may predispose them to achalasia and dysphagia, while men are more likely to develop aortic aneurysms due to increased MMP9 expression in aortic smooth muscle cells 19,20 . Our findings may reflect an inherent sex difference, but further studies are needed as previously similar resting pressures have been reported in asymptomatic women and men 17 .…”

Section: Discussionmentioning

confidence: 52%

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Impact of sex and aging on radiographic and functional parameters of the anal sphincter complex in patients with accidental bowel leakage

Dyer

Routzong

Zazueta-Damian

et al. 2023

Neurourology and Urodynamics

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Aims: Treatment outcomes for accidental bowel leakage (ABL) may be influenced by age-related sarcopenia. We sought to determine if thickness of the anal sphincter complex on endoanal ultrasound correlated with function in women and men with ABL and if women demonstrated age-related anal sphincter thinning. Methods: Consecutive patients with ABL presenting to our pelvic floor clinic from 2012 to 2017 were included. Clinical data were obtained from medical records. External anal sphincter (EAS), imaged by endoanal ultrasound at proximal, mid and distal locations, and IAS thickness were measured at 12, 3, 6, and 9 o'clock; puborectalis muscle (PRM) was measured at 4, 6, and 8 o'clock; and averaged. Anorectal manometry was conducted when clinically indicated. Data were compared using Mann-Whitney tests and linear regression. Results are reported as mean ± SD or median (IQR).Results: Women (n = 136) were younger than men (n = 26) (61 ± 13 vs. 67 ± 13 years, p = 0.02). More women than men had pelvic surgery and less had colorectal surgery, spinal disorders, or a history of smoking (p < 0.05).Eighty-two percentage of women had an anal sphincter defect versus 31% of men (p < 0.01). All anal sphincter complex components were thinner in women than men with lower squeeze and resting pressures (p < 0.03), even in nulliparous women. Mean resting pressure was lower in older 6.1 (4.6-7.8) versus younger women 8.3 (5.0-12.9) mmHg, p = 0.04.Conclusions: Women, even nulliparous, with ABL demonstrate thinner and weaker anal sphincters than men, Aging correlated with an increase in anal sphincter thickness, suggesting that age-related changes in the intrinsic components of the anal sphincter complex associated with ABL are complex and are not always well demonstrated on endoanal ultrasound.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 52%

Impact of sex and aging on radiographic and functional parameters of the anal sphincter complex in patients with accidental bowel leakage

Dyer

Routzong

Zazueta-Damian

et al. 2023

Neurourology and Urodynamics

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“…Metade da população foi de indivíduos idosos, os quais, além das alterações fisiológicas causadas pelo megaesôfago, tendem a apresentar modificações estruturais anatômicas que modificam o processo de deglutição, apesar do impacto da idade não ter sido descrito em estudo que comparou a dinâmica de deglutição de líquidos entre indivíduos idosos e jovens portadores de acalásia (DANTAS et al, 2018).…”

Section: Discussionunclassified

“…Os tempos de trânsito oral para pastoso e semilíquido na população estudada encontram-se aumentados quando comparados aos controles saudáveis de alguns estudos (GOMES et al, 2008;DANTAS, 2011;SILVA;DANTAS;FABIO, 2010) e a indivíduos com doença de Chagas (GOMES et al, 2008;DANTAS, 2011). Nessas pesquisas os tempos de trânsito orais para pastosos e semilíquidos foram menores que 1 segundo.…”

Section: Discussionunclassified

Achados da biomecânica de deglutição em pacientes com megaesôfago chagásico

Torres¹,

Guedes²,

Nóbrega³

2019

cmbio

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O megaesôfago chagásico é uma alteração do trato gastrointestinal caracterizada pela destruição ou ausência de plexos nervosos intramurais do esôfago. Alterações nutricionais e da saúde pulmonar são descritas como consequentes a esse diagnóstico. Objetivo: descrever os achados das fases oral e faríngea da deglutição em indivíduos portadores de Megaesôfago Chagásico Metodologia: participaram desta pesquisa 26 voluntários com diagnóstico confirmado de doença de Chagas. Todos realizaram avaliação videofluoroscópica da deglutição, ao deglutir sólido, líquido, semilíquido e pastoso. Resultados: observou-se prevalência do sexo feminino (73,1%), e os graus I e II de classificação do megaesôfago foram os mais encontrados. A ausência de unidades dentárias posteriores esteve presente em mais de 90% na população e o tipo de mastigação anterior foi observado em 40,7% da amostra. Durante o exame videofluoroscópico , a presença de resíduo oral, faríngeo e em região de transição faringoesofágica foi mais encontrado na consistência semilíquida, além de um tempo de trânsito oral total aumentado para o sólido. Conclusão: escape posterior, resíduos orais, faríngeos e na transição faringoesofágica na consistência semi-líquida foram os achados mais encontrados no grupo estudado.

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“…There are current themes that deserve attention from the specialist such as intestinal constipation, swallowing, diagnostic methods of gastroesophageal reflux, proton pump inhibitors, achalasia, anorectal function evaluation. The edition consists of four reviews/updates with critical analysis of the literature (1)(2)(3)(4) and nine original works of research/standardization of study methods (5)(6)(7)(8)(9)(10)(11)(12)(13) . Particularly draws attention the medical centers involved (Faculdade .…”

mentioning

confidence: 99%