Deglutição em crianças com refluxo gastroesofágico: avaliação clínica fonoaudiológica e análise videofluoroscópica

Abstract

Gastroesophageal reflux is considered cause of infants feeding disorder. Negative experience such as vomiting, regurgitation; several times may be associated to choking, dysphagia and painfull swallowing produce aversion or feed refusal and causes a break up in the swallowing and feeding processes. This study evaluated the swallowing process in children with gastroesophageal reflux (GER), confirmed clinically and radiographically. We selected 37 children, with GER and GER complaints of feeding disorders, ages range from 7 months to 37 months, mean age of 15,4 months, consisted 25 males (67,6%) and 12 females (32,4%). The control group (GC) consisted of 15 healthy children (general and nourishing states), carefully chosen for not having any symptoms of GER, repetitive breathing disorders or developmental delays. The ages varied form 6 to 38 months, with mean age of 20,5 months, being 6 males (40%) and 9 females (60%). Swallowing evaluation (functional) considered three diets consistency: liquid, semi-solid and solid, beginning with 5 ml followed by free volume taken habitually by children. Free volume of milk and 5 ml of semi-solid, mixed with barium, were used during the videofluoroscopy. Children with GER presented alteration in clinical evaluations on 64,9% (n=24) and the control group on 13,3% (n=2), swallowing less diet solid diet, presents nausea, feeding refusal, choking and irritation. Videofluoroscopy evaluation for liquids, showed laryngeal penetration on 61,8 % (n =21) , GC 33,3% (n=5), and backward compensatory movement in 64,7% (n=22) e GC 0%, it was similar for the semi-solid diet 41,2% (n=14) e GC (n=0). There was no difference in time of the swallowing phases. This study shows that children with GER present difficulties to accepting feeding although no alteration on the oropharyngeal dynamics timing of swallowing was founded.

Análise quantitativa do tempo de trânsito oral e faríngeo em síndromes genéticas

“…Although the relationship between different conditions and deglutition problems has been studied, few studies have quantitatively analyzed deglutition times in specific populations (2)(3)(4)(5)(6)(7) . Further, patients with genetic syndromes were not included in the samples in such studies (1,(8)(9)(10) .…”

Deglutição em crianças com alterações neurológicas: avaliação clínica e videofluoroscópica

“…These problems are associated to developmental and health alterations, which enclose neurological alterations, prematurity and regurgitation/vomits preprandial associated or not to gastroesophagic reflux (1)(2)(3)(4). Neurological disorders are presented with oropharyngeal dysphagia (5).…”