Clinical measurement of swallowing and proximal esophageal contractions in Chagas’ disease

Alves

Cassiani

et al. 2011

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-Context -Bariatric surgery is an effective treatment for obesity; however, after surgery the patient may have difficulty in swallowing liquid and solid foods. Objectives -To evaluate liquid ingestion in patients who had undergone bariatric surgery. Method -We studied 43 volunteers with normal body mass index (BMI) (BMI: 18.5-24.9 kg/m 2 ), 55 subjects with class III obesity (BMI: >40.0 kg/m 2 ), and 48 subjects with bariatric surgery for treatment of class III obesity. The method chosen for evaluation was the water swallowing test. The subjects drank in triplicate 50 mL of water while being precisely timed and the number of swallows were counted. Results -There was no difference between subjects with normal BMI and subjects with class III obesity. During the first 2 months after bariatric surgery the patients showed an increase in the time needed to drink the entire volume, in the number of swallows, and in the inter-swallow interval, and a decrease in the volume swallowing capacity (volume/swallowing) and swallowing flow rate (volume swallowed/second). After 2 months, the results of the swallowing measurements moved in the direction of normal values. Conclusion -Bariatric surgery may cause more intense alterations of liquid bolus swallowing within 2 months after the procedure, which moved to normal values after this time. HEADINGS -Drinking. Bariatric surgery. Obesity.

Section: Resultssupporting

confidence: 84%

Evaluation of liquid ingestion after bariatric surgery

Alves

Cassiani

et al. 2011

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“…The water swallowing test has been used in several investigations (2,3,4,5,9,12,14,15,22,23) . It is easy to perform, although its needs some training, and is inexpensive and reproducible (3) .…”

Section: Menmentioning

confidence: 99%

Possible interaction of gender and age on human swallowing behavior

Alves²,

Santos³

et al. 2011

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-Context -The swallowing behavior is affected by age and possibly by gender. However, the interaction of the effects of age and gender on swallowing is not completely known. Objective -To evaluate the possibility of interaction of gender and age on human swallowing behavior. Method -Swallowing was evaluated in 89 healthy subjects by the water swallowing test, 43 men and 46 women aged 20-40 years (younger, n = 38), 41-60 years (middle-aged, n = 31) and 61-80 years (older, n = 20). Each subject ingested in triplicate 50 mL of water while precisely timed and the number of swallows needed to ingest all the volume was counted. Results -The interval between swallows was shorter and the volume in each swallow was smaller in women compared to men. In older subjects the time to ingest the 50 mL of water was longer, the interval between swallows was longer, and swallowing flow and volume in each swallow were smaller than in younger and middle-aged subjects. The swallowing flow was lower in women compared to men in younger subjects. The volume of each swallow was smaller in women than in men in younger and middle-aged subjects. There was no difference in swallowing flow and volume between older men and older women. Conclusion -Age and gender influence swallowing behavior, with the effect of gender being more evident in younger subjects and the effect of age being more evident in men. HEADINGS -Age effect. Gender identity. Deglutition.

“…In Chagas' disease the patients have a longer pharyngeal transit duration of a paste bolus than normal volunteers (28) , have a delay in proximal esophageal response after swallows of a liquid bolus and a decrease in proximal esophageal contractions (6,7) . In idiopathic achalasia it was observed cricopharyngeal prominence and asymmetry of pharyngeal contraction (14) , increase in residual pressure in upper esophageal sphincter during opening, a decrease in the opening duration (9) and a decrease in proximal esophageal contraction (10) .…”

Section: Discussionmentioning

confidence: 99%

“…The water swallow test is inexpensive, ease to perform and give a good idea of the dynamic of ingestion. It does not give an idea of the oral, pharyngeal or esophageal phases of the swallow, but a results of all process of swallowing (1,3,5,6,13,29) . The test was able to demonstrate that there is a similar impairment, in terms of difficult for patients to ingest liquid, of water ingestion postfundoplication as seen in achalasia.…”

Section: Controls Fundoplication Chagas Achalasiamentioning

confidence: 99%

“…The esophageal alterations in achalasia cause difficulty in bolus transit through the esophageal-gastric junction (2,23) . Patients with achalasia consequent to Chagas' disease take longer to drink a volume of water, with slower flow of ingestion and a lower volume in each swallow than controls subjects (6) . As fundoplication and achalasia cause slower bolus transit and retention at the esophageal-gastric junction, our hypothesis is that they should have similar water ingestion dynamics.…”

Section: Introductionmentioning

confidence: 96%

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Postfundoplication Dysphagia Causes Similar Water Ingestion Dynamics as Achalasia

Santos

Cassiani

et al. 2016

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-Background -After surgical treatment of gastroesophageal reflux disease dysphagia is a symptom in the majority of patients, with decrease in intensity over time. However, some patients may have persistent dysphagia. Objective -The objective of this investigation was to evaluate the dynamics of water ingestion in patients with postfundoplication dysphagia compared with patients with dysphagia caused by achalasia, idiopathic or consequent to Chagas' disease, and controls. Methods -Thirty-three patients with postfundoplication dysphagia, assessed more than one year after surgery, together with 50 patients with Chagas' disease, 27 patients with idiopathic achalasia and 88 controls were all evaluated by the water swallow test. They drunk, in triplicate, 50 mL of water without breaks while being precisely timed and the number of swallows counted. Also measured was: (a) inter-swallows interval -the time to complete the task, divided by the number of swallows during the task; (b) swallowing flow -volume drunk divided by the time taken; (c) volume of each swallow -volume drunk divided by the number of swallows. Results -Patients with postfundoplication dysphagia, Chagas' disease and idiopathic achalasia took longer to ingest all the volume, had an increased number of swallows, an increase in interval between swallows, a decrease in swallowing flow and a decrease in water volume of each swallow compared with the controls. There was no difference between the three groups of patients. There was no correlation between postfundoplication time and the results. Conclusion -It was concluded that patients with postfundoplication dysphagia have similar water ingestion dynamics as patients with achalasia.