Aging Effects on Esophageal Transit Time in the Upright Position During Videofluoroscopy

Abstract

Objectives: The purpose of this study was to examine age-related effects on esophageal transit times (ETT) among healthy adult participants. Methods: A total of 175 healthy, non-dysphagic participants underwent a modified barium swallow study (MBSS), and ETT was recorded for two standardized swallowing tasks. Differences across age groups were determined using Kruskal–Wallis test. Relationships between an Esophageal Clearance (Modified Barium Swallow Impairment Profile Component 17) score and ETT were also explored. Results: No significant differences were observed in ETT across age groups for nectar-thickened liquid ( P = .335) or pudding ( P = .231) consistencies. No significant differences were observed between males and females in ETT for either the nectar ( P = .112) or pudding trial ( P = .817). For nectar, the mean ETT for patients with Component 17 scores of 2 or greater were significantly higher than that of participants with a score of 0 ( P < .0001). For pudding, participants with a score >0 demonstrated significantly higher mean ETT compared to participants with a score of 0 (with P = .0008 and P < .0001, respectively). Conclusion: Study findings failed to support age-related or sex-related differences in ETT for two standardized swallowing tasks administered during a MBSS in healthy individuals. The normative values following a standardized protocol in this study provide guidance in clinical interpretation of esophageal function.

Resiliency of the Digestive System During Aging and the Impact of Diet

“…In the upper intestine, evidence suggests that esophageal motility may be impaired with aging, but data are conflicting and depend on the outcome measured. A recent study in healthy adults ranging in age from 20 to 80 years showed no significant impact of age on total esophageal transit time for thickened foods (eg, nectar and pudding) 23 . Others have also shown no differences in overall transit time, but a recent systematic review and meta-analysis showed the most common age-related changes were a decrease in peristaltic contractility in the distal esophagus as well as a reduction in the relaxation of the lower esophageal sphincter, 24 both of which would seem to contribute to GERD.…”

“…A recent study in healthy adults ranging in age from 20 to 80 years showed no significant impact of age on total esophageal transit time for thickened foods (eg, nectar and pudding). 23 Others have also shown no differences in overall transit time, but a recent systematic review and meta-analysis showed the most common age-related changes were a decrease in peristaltic contractility in the distal esophagus as well as a reduction in the relaxation of the lower esophageal sphincter, 24 both of which would seem to contribute to GERD. Gastroesophageal reflux disease is more prevalent in the aging population, with estimates ranging from 15% to 40% of individuals 50 years or older.…”

Oesophageal fluoroscopy in adults—when and why?

“… 27 Uncertainty in the diagnosis of a delayed passage might arise due to the influence of bolus consistency and volume and a normal range of prolonged transport and intra-oesophageal stasis in the ageing population. 28 These cases highlight the need for a comprehensive evaluation of other fluoroscopic pathologies. Adding a tablet of standardized size or a solid bolus test to the examination to assess emptying time increases accuracy.…”