Oral and Pharyngeal Transit of a Paste Bolus in Chagas’ Disease

Gomes, Fernanda Rodrigues; Secaf, Marie; Kubo, Tadeu Takao Almodovar; Dantas, Roberto Oliveira

doi:10.1007/s00455-007-9101-8

Cited by 24 publications

(31 citation statements)

References 26 publications

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“…The lingering of pharyngeal residues, found in 18.2% of the patients, is similar to the findings in previous studies, 14,17,18,19 which showed a longer pharynx transit and depuration time in patients with the Chagas disease.…”

Section: Discussionsupporting

confidence: 80%

Oropharingeal dysphagia in patients with chronic Chagas disease: phonoaudiological, videofluoroscopic, and manometric evaluations

Cabral¹,

Júnior²,

Marques³

et al. 2015

Acta Fisiátrica

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Objective: To determine the frequency of episodes of laryngeal penetration and aspiration in chronic Chagas patients and to evaluate the interpreted relationship not only with the patterns displayed in videofluoroscopy and manometry, but also with clinical screening and structural and functional phonoaudiological evaluation. Method: Clinical and phonoaudiological (structural and functional) evaluation, fluoroscopy, and computed manometry were performed on all patients. Results: Twenty-two patients were included in the study, fifteen females and seven males. Age ranged between 37 and 70 years, mean 55.9 ± 10.2 years. Among the complaints in clinical screening, 18.2% were choking, 13.6% reported throat-clearing, 40.9% heartburn, 22.7% regurgitation, and 36.4% had the sensation of food stuck in the throat. Only 18.2% of patients had adequate dentition. Functional assessment of swallowing detected only 31.8% capable of functional swallowing. In videofluoroscopy, lingering residues were found in the pharynx in 18.2% of cases, followed by multiple swallows 95.4% and 100% posterior escape. There were 4 cases of grade 2 laryngeal penetration (dysphagia) and, in 82% of cases, the findings were similar for the non-occurrence of laryngeal penetration in the videofluoroscopy and in the functional assessment of swallowing. The apertures of the upper esophageal sphincter indicated a relationship with the volume of swallowed bolus. In the manometry, 42.1% of changes were found in the body of the esophagus and 5.3% in the pharynx. Conclusion: Laryngeal penetration was prevalent in 18.2% of cases with an important interpretation of the functional relationship between clinical assessment and videofluoroscopic findings regarding the absence of laryngeal penetration, with similar results in 82% of cases.

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Section: Discussionsupporting

confidence: 80%

Oropharingeal dysphagia in patients with chronic Chagas disease: phonoaudiological, videofluoroscopic, and manometric evaluations

Cabral¹,

Júnior²,

Marques³

et al. 2015

Acta Fisiátrica

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“…Clearance was the total exposure to the bolus in a ROI, which represents the interval between the arrival of the bolus head into the ROI and the departure of the bolus tail from the ROI. The definition of these ROIs and of the measurements performed were previously described and shown (1,6,7,16) . The statistical analysis of transit and clearance times and the amount of residues was made using a linear model with mixed effects (14) .…”

Section: Methodsmentioning

confidence: 99%

Effect of a Bitter Bolus on Oral, Pharyngeal and Esophageal Transit of Healthy Subjects

Alves

Secaf

Dantas

2013

Arq. Gastroenterol.

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-Context -During swallowing, boluses stimulate sensory receptors of the oral, pharyngeal, laryngeal, and esophageal regions. Sweet and tasteless foods are more acceptable for swallowing than bitter foods. A bitter bolus is unpleasant for most subjects. Our hypothesis was that the ingestion of a bitter bolus might alter the oral behavior, pharyngeal and esophageal transit when compared to a sweet bolus. Objective -To evaluate whether the bitter taste of a liquid bolus causes alteration on oral, pharyngeal and/or esophageal transit in normal subjects in comparison with sweet bolus. Method -Scintigraphic evaluation of oral, pharyngeal and esophageal transit was performed in 43 asymptomatic subjects, 22 women and 21 men, ages 23-71 years, without problems with the ingestion of liquid and solid foods, and without digestive, cardiac or neurologic diseases. Each subject swallowed in random sequence and at room temperature 5 mL of a liquid bolus with bitter taste, prepared with 50 mL of water with 2 g of leaves of Peumus boldus, heated until boiling (boldus tea), and 5 mL of a liquid bolus with sweet taste, prepared with 50 mL of water with 3 g of sucrose, both labeled with 37 MBq of technetium phytate (Tc 99m ). Results -There was no difference between the bitter bolus and the sweet bolus in mouth, pharynx and esophageal transit and clearance duration and in the amount of residues. Conclusion -A bitter bolus, considered an unpleasant bolus, does not alter the duration of oral, pharyngeal and esophageal phases of swallowing, when compared with a sweet bolus, considered a pleasant bolus.

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“…However, pharyngeal changes have been demonstrated in these patients. Two studies [6,7] have analyzed the oral and pharyngeal transit in patients with Chagas' disease using the scintigraphic method. With swallows of a liquid bolus the authors found that these patients had a longer oral transit time and longer pharyngeal clearance than healthy subjects [6].…”

Section: Introductionmentioning

confidence: 99%

Videofluoroscopic Evaluation of Swallowing in Chagas’ Disease

2011

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Dysphagia is the most common digestive symptom reported by patients with Chagas' disease. The condition results from abnormalities of esophageal motility. Our hypothesis is that there are also alterations of oral and pharyngeal transit during swallowing. We studied by videofluoroscopy the oral and pharyngeal transit during swallowing in 17 patients with dysphagia, a positive serologic test for Chagas' disease, and radiologic demonstration of esophageal involvement. The study also included 15 asymptomatic healthy volunteers. Each subject swallowed in duplicate 5 and 10 ml of liquid and paste barium boluses. Chagas' disease patients had a longer oropharyngeal transit with the 5-ml liquid bolus (p = 0.03), and a longer oral transit (p = 0.01) and pharyngeal transit (p = 0.04) with the 10-ml liquid bolus than controls. There was no difference between patients and controls with swallows of the 5-ml paste bolus. With swallows of the 10-ml paste bolus, the oropharyngeal transit (p = 0.05), pharyngeal transit (p = 0.04), pharyngeal clearance (p = 0.02), and UES opening (p = 0.01) took a longer amount of time in Chagas' disease patients than in controls. We conclude that the duration of pharyngeal transit is longer in patients with Chagas' disease than in normal subjects, especially with a bolus of pasty consistency and a volume of 10 ml.

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Oral and Pharyngeal Transit of a Paste Bolus in Chagas’ Disease

Cited by 24 publications

References 26 publications

Oropharingeal dysphagia in patients with chronic Chagas disease: phonoaudiological, videofluoroscopic, and manometric evaluations

Oropharingeal dysphagia in patients with chronic Chagas disease: phonoaudiological, videofluoroscopic, and manometric evaluations

Effect of a Bitter Bolus on Oral, Pharyngeal and Esophageal Transit of Healthy Subjects

Videofluoroscopic Evaluation of Swallowing in Chagas’ Disease

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