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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Conventional oesophageal manometry is seldom accompanied by symptoms and may indeed be normal in patients with a history of dysphagia. We have recently shown that oesophageal manometry during eating may be helpful in the evaluation of patients with dysphagia but there has been little systematic comparison of fed oesophageal motor patterns with conventional clinical manometry. Oesophageal manometry in response to water swallows and during eating was therefore examined in 58 consecutive patients who had been referred for clinical oesophageal function studies. The patients were divided into three groups according to the percentage of peristaltic activity during conventional manometry: group 1 (n = 21) had 100% peristalsis; group 2 (n = 29) had 1-99% peristalsis and group 3 (n = 8) were aperistaltic. All the patients in group 3 had achalasia and remained aperistaltic during eating, however, was less than with water swallows in both group 1 (53% compared with 100%) and group 2 (49% compared with 82.3%) patients. Synchronous contractions and non-conducted swallows were correspondingly increased during eating. Although there was a significant correlation between the amplitude of peristaltic contractions with water and bread in groups 1 and 2, mean peristaltic amplitudes were less with bread than with water swallows. The data show that there are substantial differences in the distal oesophageal motility patterns produced by water swallows and by eating. Conventional manometry with water swallows does not allow prediction of the fed oesophageal motility pattern, except in patients with achalasia.
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PMID:Systematic comparison of conventional oesophageal manometry with oesophageal motility while eating bread. 175 52

The authors report 200 cases of cardiopexy with the ligamentum teres (Rampal-Marchal's procedure) associated with a 180 degree posterior fundoplication, in the surgical treatment of gastroesophageal reflux. 200 patients with severe reflux (76% oesophagitis) were operated on with this procedure over a 10 year period. Symptoms of reflux disappeared immediately in 99% cases, with healing of oesophagitis in 124 out of the 127 patients controlled with endoscopy, and a significant increase of inferior sphincteric pressure (from 11 cm H2O to 25 cm H2O). Objective controls by post-prandial pHmetry evidenced persistant reflux with 10 patients, but 9 of them are totally free of symptoms. Operative mortality was 1.5%. Transient dysphagia was observed in 32% cases. All the patients were reviewed with a mean follow up of 23 months. 4 clinical recurrences of reflux were observed (2%) but no oesophagitis was found on endoscopic controls with these 4 patients, and only one had to be reoperated on. Actuarial chance to remain free of recurrence was estimated at 97.8% up to 48 months according to the Kaplan-Maier's method. Cardiopexy with the ligamentum teres ensures the lengthening of the abdominal portion of the oesophagus and anchors the antireflux assembly within the pressure environment of the abdomen in a strong and flexible way. It seems to be the best procedure for the treatment of GE reflux.
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PMID:[Cardiopexy using the hepatic ligament in the treatment of gastroesophageal reflux. Apropos of 200 cases]. 179 73

The purposes of this paper are to evaluate degree of dysphagia at the pharyngeal stage of swallowing in patients with polymyositis. A catheter with three diode transducers 5 cm apart was swallowed through the nose into the upper esophagus. Firstly a patient was commanded to drink water of 2 ml at about five second intervals, and the swallowing pressures were recorded on condition that the speed of paper recording and catheter pull-through is the same 1 mm/sec. Secondly the swallowing pressures were recorded on condition that the middle transducer is fixed at the level of the upper esophageal sphincter and the speed of paper recording is 5 mm/sec. Thirdly the resting pressure of upper esophageal sphincter was recorded on the same condition of the first recording. The results were as follows: (1) All eight patients showed extremely low swallowing pressure at the all level of the pharynx compared with healthy men. (2) Four patients showed poor relaxation of the upper esophageal sphincter. (3) The resting pressure of the upper esophageal sphincter was low in seven. In polymyositis manometrical study of the pharynx and the pharyngoesophageal sphincter is a useful method for evaluating swallowing function.
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PMID:[Manometrical study of the pharynx and the pharyngoesophageal sphincter in patients with polymyositis]. 204 47

Scintigraphic studies of the oropharyngeal transit of a liquid bolus were performed in 15 healthy controls, 12 patients with symptoms of oral-pharyngeal dysphagia, and 13 patients with neuromuscular disease, who did not have dysphagia. Gamma camera imaging of the head, neck, and upper thorax was undertaken, in the lateral projection, during the swallowing of the radiolabeled bolus of water. Inspection of summed images permitted the selection of regions of interest (ROI) to represent the mouth, pharynx, and upper esophagus. Transit times between each ROI were calculated and compared. Significant prolongation of bolus transit time between the mouth and esophagus was present in both patients with and without dysphagia (0.59 +/- 0.38 sec and 0.33 +/- 0.7 sec; mean +/- SD, respectively) compared with controls (0.26 +/- 0.04 sec P less than 0.001, P less than 0.01, respectively, Mann-Whitney U test). Repeat studies in 25 individuals indicated that the transit measurements were more reproducible between swallows in normal subjects than in patients with symptoms. Deglutitive scintigraphy provides a noninvasive technique for the quantitative study of swallowing and its disorders.
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PMID:Scintigraphic measurement of oropharyngeal transit in man. 220 87

The symptoms and presentations of gastroesophageal reflux disease are rather numerous. These include the typical symptoms, such as heartburn, regurgitation, water brash, or dysphagia. However, reflux may also be responsible for such symptoms as hoarseness, pulmonary aspiration, or asthma. It may also be an important cause of noncardiac chest pain. Thus, gastroesophageal reflux disease may be considered a disease with more than just "esophageal" symptoms.
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PMID:The spectrum of the symptoms and presentations of gastroesophageal reflux disease. 222 66

The purposes of this paper are to evaluate degree of dysphagia at the pharyngeal stage of swallowing in patients with myasthenia gravis (Osserman IIB). A catheter with three diode transducers 5 cm apart was swallowed through the nose into the upper esophagus. Firstly a patient was commanded to drink water of 1 ml at about five second intervals, and the swallowing pressures were recorded on condition that the speed of paper recording and catheter pull-through is the same 1 mm/sec. Secondly the swallowing pressures were recorded on condition that the middle transducer is fixed at the level of the upper esophageal sphincter and the speed of paper recording is 5 mm/sec before and after intravenous injection of 10 mg edrophonium chloride. Thirdly the resting pressure of upper esophageal sphincter was recorded on the same condition of the first recording. The results were as follows: (1) All seven patients showed extremely low swallowing pressure at the all level of the pharynx compared with healthy men. (2) At the edrophonium test all seven patients revealed increased percentage of swallowing pressure. (3) One patient showed poor relaxation of the upper esophageal sphincter. (4) The resting pressure of the upper esophageal sphincter was low compared with control. In myasthenia gravis manometric study of the pharynx and the pharyngoesophageal sphincter is a useful method for evaluating swallowing function.
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PMID:[Manometric study of the pharynx and pharyngoesophageal sphincter in myasthenia gravis]. 226 3

Data from 357 conscious stroke patients taking part in an acute intervention trial and assessed within 48 hours of the onset of symptoms, were used to investigate the prevalence and natural history of swallowing problems. Nearly 30% of patients with single-hemisphere strokes were initially found to have difficulty swallowing a mouthful of water, but in most of those who survived, the deficit had resolved by the end of the first week. Strong correlations were found between dysphagia and speech impairment (comprehension and expression) and with facial weakness, but there was no association with the side of the stroke. After controlling for other markers of overall stroke severity such as conscious level, urinary continence, white blood cell count and strength in the affected limbs, swallowing impairment still showed a significant inverse correlation with functional ability at 1 and 6 months. These results indicate that, even if dysphagia itself is not responsible for much excess mortality in acute stroke, it might still lead to complications which hamper functional recovery.
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PMID:The natural history and functional consequences of dysphagia after hemispheric stroke. 256 84

Localized thyroid carcinoma involving the base of the tongue was diagnosed in 3 dogs examined because of a midline cervical mass rostroventral to the larynx. These masses had been present for 4 to 12 months and were firm, nonsensitive, and fixed in position. One dog had progressive dysphagia and dyspnea. Masses were surgically excised together with the base of the tongue and portions of the hyoid apparatus. Severe dyspnea that developed immediately after surgery in 1 dog was managed by tracheostomy intubation for 4 days. Transient dysphagia developed in all dogs. Hydration was maintained by IV fluid administration until water and food of gruel consistency could be swallowed 1 to 6 days after surgery. Consistency of food was gradually thickened to normal, as swallowing improved 6 days to 2 months after surgery. One dog developed aspiration pneumonia that resolved after antimicrobial administration and improved swallowing that prevented further aspiration. After 9 months, 3 years, and 6 years, the dogs were clinically normal.
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PMID:Surgical excision of ectopic thyroid carcinoma involving the base of the tongue in dogs: three cases (1980-1987). 259 48

In order to define a suitable volume of barium to be delivered to patients during the radiographic evaluation of pharyngoesophageal function during swallowing, three different age groups of nondysphagic volunteers were studied. Subjects randomly swallowed boluses of water, barium, and Coca-Cola. The size of a normal thin liquid bolus was 21 ml (SD +/- 5 ml). We intend to include this information to compare different bolus sizes in cineradiographic examination of patients with swallowing complaints.
Dysphagia 1989
PMID:Determining normal bolus size for thin liquids. 264 Jan 73

This investigation concerned the effect of different bolus volumes on the characteristics of lingual propulsive activity in swallowing. Young normal subjects were asked to perform dry swallows and swallows of 5, 10, and 15 ml of water. Tongue activity was recorded by tracking multiple gold pellets affixed to the tongue, utilizing the specialized research capabilities of the X-ray Microbeam facility at the University of Wisconsin. The major differences were between dry and liquid swallows, with dry swallows showing smaller range of movement, higher tongue position at the initiation of lingual propulsive activity, a slightly different direction of motion, a humped or flat rather than grooved cross-sectional contour of the tongue, lower peak velocity of motion, and slower progression of activity from tongue blade to dorsum. Within the 5-15 ml range of liquid bolus volumes, fewer consistent differences were found as a function of bolus size, and some marked individual differences in swallowing patterns were seen. Data are presented on normal within-subject variability in swallowing, with discussion of the possible contribution of sensory assessment of bolus size to the modification of oral and pharyngeal characteristics of swallowing.
Dysphagia 1989
PMID:Dynamic aspects of lingual propulsive activity in swallowing. 264 Jan 86


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