Dysphagia
. Esophageal venting following air insufflation may occur by secondary peristalsis or by isolated transient lower esophageal sphincter relaxation (TLESR). To identify factors determining venting by these two mechanisms, we analyzed the responses to esophageal air insufflation in 4 infants and in 2 adults. We used a nine-lumen dual-Dent-sleeve manometric catheter with an air insufflation esophageal...
. Feeding difficulty necessitating tube feeding after the infantile period was seen in 3 children with oculo-auriculo-vertebral spectrum. Videofluorographic imaging showed impaired pharyngeal function, which was thought to result from dysplasia of the pharyngeal muscles. Note should be made of feeding difficulty in patients with oculo-auriculo-vertebral spectrum.
. To assess the frequency and natural history of swallowing problems following an acute stroke, 121 consecutive patients admitted within 24 hours of the onset of their stroke were studied prospectively. The ability to swallow was assessed repeatedly by a physician, a speech and language therapist, and by videofluoroscopy. Clinically 51% (61/121) of patients were assessed as being at risk of aspiration...
. Eating impairment is well documented in the late stage of Alzheimer's disease (AD) but when these eating changes actually begin in the disease process is not known. Eating was defined as consisting of two components, self-feeding and swallowing. Self-feeding and swallowing of healthy elderly were compared with a group of individuals with mild AD. AD subjects received significantly more partner-initiated...
. The gastrointestinal tract, and especially the esophagus, is frequently involved in neurological diseases; however, objective studies of gut motor function are few. We carried out an esophageal manometric study in 18 patients with various stages of Parkinson's disease (4 stage I, 4 stage II, 7 stage III, and 3 stage IV) to evaluate the function of the viscus in this disease. Clinical assessment...
. A hypothetical discussion of the cause of swallowing sounds is presented. It is suggested that the pharynx contains a number of valves and pumps that produce reverberations within the pharynx to generate swallowing sounds. As heart sounds are propagated via vibration of muscles and valves, it is further suggested that an analogy exists between the generation of heart sounds and swallowing sounds...
Abstract. Some patients with Chagas disease and apparent normal esophageal function complain of dysphagia. With the objective of investigating the esophageal motility of these patients we studied the esophageal contraction amplitude, duration, velocity, and lower esophageal sphincter (LES) pressure of 34 patients with a positive serologic test for Chagas disease, normal radiologic esophageal examination,...
. Cervical osteophytes are common in the aging population. Dysphagia induced by cervical osteophytes, although uncommon, is an important and treatable cause of dysphagia that must be identified during the modified barium swallow. Previous authors have described osteophyte impingement as a cause for dysphagia. This report describes a case of this classic obstructive osteophytic dysphagia and one of...
Abstract. This is a prospective study of 100 consecutive stroke patients. Within 24 h after stroke onset they were asked specifically about swallowing complaints and subjected to a clinical examination including neurologic examination, Mini-Mental test, and Barthel score. Dysphagic patients were examined with the repetitive oral suction swallow test (the ROSS test) for quantitative evaluation of oral...
Abstract. Cervical osteophytes are common in the aging population. Dysphagia induced by cervical osteophytes, although uncommon, is an important and treatable cause of dysphagia that must be identified during the modified barium swallow. Previous authors have described osteophyte impingement as a cause for dysphagia. This report describes a case of this classic obstructive osteophytic dysphagia and...
. Patients who report dysphagia, but have no detectable physical defect, have often been diagnosed as having an eating disorder. This diagnosis was evaluated by administering the Eating Disorders Inventory-2 (EDI-2) and a measure of distress, the Symptom Checklist-90 (SCL-90R), to a sample of 21 adult psychogenic dysphagia patients (PDPs). Their EDI-2 responses were then compared with samples of...
Abstract. Patients who report dysphagia, but have no detectable physical defect, have often been diagnosed as having an eating disorder. This diagnosis was evaluated by administering the Eating Disorders Inventory-2 (EDI-2) and a measure of distress, the Symptom Checklist-90 (SCL-90R), to a sample of 21 adult psychogenic dysphagia patients (PDPs). Their EDI-2 responses were then compared with samples...
. The pharynx is important for a normal swallow and it has been suggested that pharmacological agents may play a role in the management of pharyngeal dysphagia, but none have been formally evaluated. A pilot double-blind, placebo-controlled study was undertaken in 17 hospitalized patients with persistent dysphagia 2 weeks after stroke. Patients were randomized to treatment with slow-release nifedipine...
. The purpose of this study was to investigate the relationships of four intensities of tactile-thermal application (TTA) to changes in duration of stage transition (DST) and performance on a newly designed scale of penetration and aspiration by groups of patients made dysphagic by stroke. Patients were randomly assigned to receive 150, 300, 450, or 600 trials of TTA during each of 2 weeks. Data...
Abstract. The purpose of this study was to investigate the relationships of four intensities of tactile-thermal application (TTA) to changes in duration of stage transition (DST) and performance on a newly designed scale of penetration and aspiration by groups of patients made dysphagic by stroke. Patients were randomly assigned to receive 150, 300, 450, or 600 trials of TTA during each of 2 weeks...
. Some patients with Chagas' disease and apparent normal esophageal function complain of dysphagia. With the objective of investigating the esophageal motility of these patients we studied the esophageal contraction amplitude, duration, velocity, and lower esophageal sphincter (LES) pressure of 34 patients with a positive serologic test for Chagas' disease, normal radiologic esophageal examination,...
. This is a prospective study of 100 consecutive stroke patients. Within 24 h after stroke onset they were asked specifically about swallowing complaints and subjected to a clinical examination including neurologic examination, Mini-Mental test, and Barthel score. Dysphagic patients were examined with the repetitive oral suction swallow test (the ROSS test) for quantitative evaluation of oral and...
Abstract. A hypothetical discussion of the cause of swallowing sounds is presented. It is suggested that the pharynx contains a number of valves and pumps that produce reverberations within the pharynx to generate swallowing sounds. As heart sounds are propagated via vibration of muscles and valves, it is further suggested that an analogy exists between the generation of heart sounds and swallowing...
. The traditional bedside dysphagia evaluation has not been able to identify silent aspiration because the pharyngeal phase of swallowing could not be objectively assessed. To date, only videofluoroscopy has been used to detect silent aspiration. This investigation assessed the aspiration status of 400 consecutive, at risk subjects by fiberoptic endoscopic evaluation of swallowing (FEES). Our study...