Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Drug-induced injury of the oesophagus is a common cause of oesophageal complaints. 'Pill-induced' oesophagitis is associated with the ingestion of certain drugs and accounts for many cases of erosive oesophagitis. To date, more than 70 drugs have been reported to induce oesophageal disorders. Antibacterials such as doxycycline, tetracycline and clindamycin are the offending agents in more than 50% of cases. Other commonly prescribed drugs that cause oesophageal injury include aspirin (acetylsalicylic acid), potassium chloride, ferrous sulfate, quinidine, alprenolol and various steroidal and nonsteroidal anti-inflammatory agents. However, many physicians and even more patients are not aware of this problem. Capsules or tablets are commonly delayed in their passage through the oesophagus. Highly caustic coatings, direct medication injury and poor oesophageal clearance of pills can lead to acute inflammation. Oesophageal damage occurs when the caustic contents of a drug remain in the oesophagus long enough to produce mucosal lesions. Taking medications at bedtime or without fluids is a common cause of oesophagitis. The possibility of drug-related damage should be suspected in all cases of oesophagitis, chest pain and dysphagia. History and gastrointestinal endoscopy will confirm the diagnosis. Treatment is supportive, although acid reduction is used frequently as an adjunct. This review reflects the current state of knowledge in this field.
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PMID:Drug-induced oesophageal disorders: pathogenesis, incidence, prevention and management. 1073 47

FROM DISCOVERY TO CLINICAL DIAGNOSIS: Dysphagia is easy to diagnose in its acute stage and when complicating a known neurological disease. However diagnosis may be greatly delayed when expressed by respiratory or nutritional symptoms, or when the patient presents cognitive disorders, as is frequent in the elderly. In such instances, simple tests such as the water test are clearly indicated. However, although they are reliable for diagnosing dysphagia, they are not precise in diagnosis of inhalation. Clinical examination is essential for diagnosing the etiology of the disorder. In the absence of clinical orientation, a nasofibroscopy is mandatory and digestive endoscopy debatable. SPECIALIZED EXAMINATIONS: The first-line supplementary examination is a videoradiography. It consists in the patient swallowing a liquid or solid barium sulfate bolus. This detects any anatomical or functional abnormalities. It is the examination of choice for the diagnosis of inhalation and its mechanism. Videoendoscopy is complementary to videoradiography. It can be conducted in first intention in patients who cannot be transported to the radiology unit. It provides precise information on glottal closing and pharyngeal contraction. IMPACT ON MANAGEMENT: In a restricted number of patients, the precise knowledge of the mechanism of dysphagia can help to orientate specific treatment. In others, such examinations will orient re-education, postural adaptation and the modification of food texture. In many patients, precise diagnosis of the mechanism at the origin of dysphagia has no impact on the management of dysphagia.
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PMID:[Deglutition disorders in the elderly. Evaluation methods]. 1175 43

Barium sulfate is an agent used widely as a contrast material for imaging studies of the gastrointestinal tract and is not inherently toxic to lung tissue. Aspiration of barium sulfate has been reported on rare occasions, but is more frequently seen in patients with underlying anatomical or neurological defects such as head and neck deformity, esophageal stricture, diverticulum or fistula. We report a previously healthy child suffered from massive aspiration of barium sulfate during the investigation of dysphagia due to an impacted foreign body in the esophagus. Massive aspiration of barium sulfate is potentially life-threatening because of mechanical interference with gas exchange. An obstruction of the esophagus should be considered in the differential diagnosis for children with acute dysphagia and barium contrast should be used with great care in such instance.
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PMID:Massive aspiration of barium sulfate during an upper gastrointestinal examination in a child with dysphagia. 1576 94

We examined the dynamics of capsule swallowing by healthy young men using the anterior-posterior view of videofluoroscopy as a first step in a study on capsule swallowing by dysphagic patients. The subjects were 14 healthy men who did not have any complaint of dysphagia. They were asked to swallow a #4 hard gelatin capsule filled with barium sulfate with 15 ml of water during the videofluoroscopic examination. This examination was repeated three times for each subject (total of 42 trials). In four of the 14 subjects, a swallowed capsule was retained at the upper esophageal sphincter, or the broncho-aortic constriction of the esophagus, or the lower esophageal sphincter. Except where retention occurred, the average capsule transit time from the mouth to the stomach was 6.0 +/- 2.4 s. Three of the four subjects who had capsule retention did not realize that the swallowed capsule was retained en route to the stomach. By considering the dynamics of swallowing a capsule with 15 ml of water in healthy men, we should be able to reveal the dynamics of capsule swallowing in dysphagic patients, and the capsule transit time from the mouth to the stomach.
Dysphagia 2006 Oct
PMID:Dynamics of capsule swallowing by healthy young men and capsule transit time from the mouth to the stomach. 1721 87

Esophageal diverticulum and perforation were diagnosed in a horse. The condition was characterized clinically by dysphagia, polypnea, diffuse swelling of the ventral aspect of neck and cutaneous fistula. Endoscopic examination revealed the presence of food material in the guttural pouch. A barium sulfate esophagram was performed to outline the diverticulum.Exploratory surgery confirmed esophageal perforation and entrapment of food material between the muscular planes of the cervical region and the horse was euthanized. At necropsy a food-filled periesophageal tract was found extending from the esophageal rupture to the left guttural pouch.
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PMID:Diverticulum and fistula of the lower cervical esophagus in a horse. 1742 40

Polioencephalomalacia (PEM), hereafter used to refer to the specific lesion of cerebrocortical necrosis, developed in 11 of 110 mature cattle on pasture in central Saskatchewan. The primary water source contained a markedly elevated level of sodium sulfate (7200 ppm). The significant clinical findings of the herd investigation included depression, ataxia, cortical blindness, dysphagia, and death. Diagnosis of PEM was confirmed by histopathological evidence of cerebrocortical and subcortical necrosis with microvascular fibrinoid necrosis predominantly in the thalamic region of three affected cattle. The histopathology of sulfate-associated PEM observed in this herd appears to be unique and its features are presented and discussed. Mean levels for serum transketolase, copper, red blood cell transketolase activity, and thiamine (vitamin B(1)) in all exposed young (n = 100) and mature (n = 99) animals did not reveal evidence of deficiencies. Although the blood thiamine status of the seven surviving, affected animals was not evaluated before treatment with exogenous thiamine, 199 members of the herd had blood thiamine levels within the reference range at the time of the outbreak. The outbreak resolved after cattle were moved to a water source containing acceptable levels of sodium sulfate.
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PMID:Polioencephalomalacia in cattle consuming water with elevated sodium sulfate levels: A herd investigation. 1742 82

The tongue plays a vital role in swallowing actions. However, tongue muscles have been understudied, and it is unclear if tongue muscles are homogeneous with respect to muscle fiber-type distribution. We examined myosin heavy chain (MHC) composition of anterior, medial, and posterior sections of the genioglossus muscle (GG) using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) in ten adult (9 months old) male Fischer 344/Brown Norway hybrid rats. We found that Type IIx MHC predominated in the anterior, medial, and posterior regions of the GG muscle (p=0.002), followed by IIa, then IIb. The anterior GG contained a significantly greater (p=0.004) proportion of Type IIa than did the medial or posterior regions, while the posterior GG contained a significantly greater (p=0.002) proportion of Type IIb MHC than did the medial or anterior GG. Accordingly, we found variable expression of MHC isoforms across anterior, medial, and posterior portions of the GG muscle, with more fast-contracting isoforms found posteriorly. Because motor control of the tongue requires precise and rapid movements for bolus manipulation and airway protection, variable expression of MHC isoforms along the anteroposterior axis of the GG muscle may be required to efficiently achieve deglutition and maintenance of airway patency.
Dysphagia 2007 Jul
PMID:Biochemistry of anterior, medial, and posterior genioglossus muscle in the rat. 1745 85

Vomiting after feeding is a symptom of gastroesophageal reflux (GER) and of eosinophilic esophagitis (EE), which are considered to be a cause of infant feeding disorder. The objective of the present study was to evaluate swallowing in children with feeding disorder manifested by vomiting after feeding. Using clinical and videofluoroscopic methods we studied the swallowing of 37 children with vomiting after feeding (mean age=15.4 months), and of 15 healthy children (mean age=20.5 months). In the videofluoroscopic examination the children swallowed a free volume of milk and 5 ml of mashed banana, both mixed with barium sulfate. We evaluated five swallows of liquid and five swallows of paste. The videofluoroscopic examination was recorded at 60 frames/s. Patients had difficulty during feeding, pneumonia, respiratory distress, otitis, and irritability more frequently than controls. During feeding, children with vomiting, choke were irritable, and refused food more frequently than controls, and during the videofluoroscopic examination the patients had more backward movement of the head than controls for both the liquid and paste boluses. There was no difference in the timing of oral swallowing transit, pharyngeal swallowing transit, or pharyngeal clearance between patients and controls. We conclude that children with vomiting after feeding may have difficulties in accepting feeding, although they have no alteration of oral and pharyngeal phases of swallowing.
Dysphagia 2008 Jun
PMID:Evaluation of swallowing in children with vomiting after feeding. 1797 60

In this study, the effects of atropine sulfate (atropine) on swallowing and cough reflex were evaluated in the two experimental models in conscious dogs. To evaluate the effects of atropine on swallowing, 1 mL of marker (contrast medium) was injected into the pharynx under X-ray exposure to induce swallowing. Baclofen, used as a positive control, caused marker congestion in the upper esophagus. In our experimental model, atropine (0.02 and 0.1 mg/kg, i.v.) dose-dependently increased not only the number of marker congestions but also that of the swallows. In addition, atropine significantly shortened the onset of first swallowing. In the evaluation of atropine effects on electrically evoked cough reflex induced by two electrodes implanted into the trachea, atropine strongly inhibited the number of coughs at 0.01 or 0.05 mg/kg accompanied with 0.01 or 0.05 mg/kg per hour (i.v.), respectively. These findings indicate that atropine has the potential of causing aspiration pneumonia through induction of swallowing disorder and inhibition of the cough reflex.
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PMID:Swallowing disorder and inhibition of cough reflex induced by atropine sulfate in conscious dogs. 1834 13

A videofluorographic (VF) swallowing study was performed on 22 healthy volunteers to observe the complete mastication and swallowing phases for Japanese udon noodles and white rice. The hardness, stickiness, and cohesiveness of food samples were measured using a food texture analyzing system. VF images were acquired using a versatile fluoroscopic unit and barium sulfate was used as a contrast medium. Udon noodles had a harder and smoother food texture than white rice. Fewer chewing movements and more stage 2 transport were seen during the consumption of udon noodles than for white rice.
Dysphagia 2011 Sep
PMID:Videofluorographic evaluation of mastication and swallowing of Japanese udon noodles and white rice. 2082 Aug 8


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