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Bolus effects swallowing

Ivan M Lang, Bidyut K Medda, Sudarshan R Jadcherla, Reza Shaker
Stimulation of the esophagus activates the pharyngeal swallow response (EPSR) in human infants and animals. The aims of this study were to characterize the stimulus and response of the EPSR, and to determine the function and mechanisms generating the EPSR. Studies were conducted in 46 decerebrate cats in which pharyngeal, laryngeal and esophageal motility was monitored using EMG, strain gauges, or manometry. The esophagus was stimulated by balloon distension or luminal fluid infusion. We found that esophageal distension increased the chance of occurrence of the EPSR, but the delay was variable...
September 15, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
Tomonori Shimbo, Takeshi Adachi, Susumu Fujisawa, Mai Hongoh, Takayoshi Ohba, Kyoichi Ono
The lower esophageal sphincter (LES) is a specialized region of the esophageal smooth muscle that allows the passage of a swallowed bolus into the stomach. Nitric oxide (NO) plays a major role in LES relaxation. Nicorandil possesses dual properties of a NO donor and an ATP-sensitive potassium channel (KATP channel) agonist, and is expected to reduce LES tone. This study investigated the mechanisms underlying the effects of nicorandil on the LES. Rat LES tissues were placed in an organ bath, and activities were recorded using an isometric force transducer...
August 2016: Journal of Pharmacological Sciences
Alison Perry, Siew Hwa Lee, Susan Cotton, Catriona Kennedy
BACKGROUND: Head and neck cancer treatment has developed over the last decade, with improved mortality and survival rates, but the treatments often result in dysphagia (a difficulty in swallowing) as a side effect. This may be acute, resolving after treatment, or remain as a long-term negative sequela of head and neck cancer (HNC) treatment. Interventions to counteract the problems associated with dysphagia include swallowing exercises or modification of diet (bolus texture, size), or both...
2016: Cochrane Database of Systematic Reviews
Nicole M Rogus-Pulia, Charles Larson, Bharat B Mittal, Marge Pierce, Steven Zecker, Korey Kennelty, Amy Kind, Nadine P Connor
Patients treated with chemoradiation for head and neck cancer frequently develop dysphagia. Tissue damage to the oral tongue causing weakness along with decreases in saliva production may contribute to dysphagia. Yet, effects of these variables on swallowing-related measures are unclear. The purpose of this study was (1) to determine effects of chemoradiation on tongue pressures, as a surrogate for strength, and salivary flow rates and (2) to elucidate relationships among tongue pressures, saliva production, and swallowing efficiency by bolus type...
October 2016: Dysphagia
Rachel W Mulheren, Erin Kamarunas, Christy L Ludlow
Sour stimuli have been shown to upregulate swallowing in patients and in healthy volunteers. However, such changes may be dependent on taste-induced increases in salivary flow. Other mechanisms include genetic taster status (Bartoshuk et al., 2004) and differences between sour and other tastes. We investigated the effects of taste on swallowing frequency and cortical activation in the swallowing network and whether taster status affected responses. 3ml boluses of sour, sour with slow infusion, sweet, water, and water with infusion were compared on swallowing frequency and hemodynamic responses...
August 3, 2016: Journal of Neurophysiology
Heather Shaw Bonilha, Terri Treman Gerlach, Lori Ellen Sutton, Amy Elizabeth Dawson, Katlyn McGrattan, Paul J Nietert, Dimitar D Deliyski
PURPOSE: Clinicians commonly teach patients alternative clearing behaviors to reduce coughing and hard throat clearing with the assumption that these behaviors clear mucus from the vocal folds. Yet there is limited evidence of the effectiveness of these alternative behaviors at clearing mucus. This study's purpose was to evaluate the efficacy of reducing laryngeal mucus aggregation using alternative approaches in comparison with hard coughing and hard throat clearing in people with and without voice disorders...
July 25, 2016: Journal of Voice: Official Journal of the Voice Foundation
Tarini V Ullal, Philip H Kass, Jeffrey L Conklin, Peter C Belafsky, Stanley L Marks
OBJECTIVE To validate the use of high-resolution manometry (HRM) in awake, healthy dogs and compare the effects of bolus type (liquid vs solid) and drug treatment (saline [0.9% NaCl] solution [SS] vs cisapride) on esophageal pressure profiles. ANIMALS 8 healthy dogs. PROCEDURES In a crossover study, each dog received SS (10 mL) IV, and HRM was performed during oral administration of 10 boluses (5 mL each) of water or 10 boluses (5 g each) of canned food. Cisapride (1 mg/kg in 60 mL of SS) was subsequently administered IV to 7 dogs; HRM and bolus administration procedures were repeated...
August 2016: American Journal of Veterinary Research
Felice Schnoll-Sussman, Philip O Katz
Esophageal dysphagia in the elderly is a common clinical problem. Achalasia is a disease in which there is loss of ganglion in the myenteric plexus of the lower esophageal sphincter resulting in incomplete relaxation of that muscle causing a functional obstruction to outflow. Treatment is aimed at reducing sphincter pressure allowing for gravity and the oral portion of the swallow to propel the bolus through the esophagus. Pneumatic dilatation, Heller myotomy (laparoscopic), and the newest procedure peroral endoscopic esophageal myotomy (POEM) are all reasonable options for effective treatment even in the elderly...
September 2016: Current Treatment Options in Gastroenterology
Yoshihiko Kumai, Yasuhiro Samejima, Masayuki Watanabe, Eiji Yumoto
: To determine the factors inducing aspiration following esophagectomy with three-field lymph node dissection (3FL) and the effect of the chin-down maneuver combined with supraglottic swallow (CDSS). Retrospective analysis of a consecutive case series. Videofluoroscopic (VF) evaluations of 25 patients who consulted with our out-patient clinic from 2006 to 2012 for swallowing dysfunction following esophagectomy with 3FL without tracheostomy were reviewed. The penetration aspiration scale (PAS) was used for evaluation...
July 16, 2016: European Archives of Oto-rhino-laryngology
Arwen Jackson, Jennifer Maybee, Maura K Moran, Kristine Wolter-Warmerdam, Francis Hickey
Aspiration is an often unrecognized comorbidity in children with Down syndrome with serious medical consequences. This retrospective chart review of swallow study reports characterizes oral and pharyngeal phase dysphagia and diet modifications on videofluoroscopic swallow studies (VFSS) in a large cohort of children with Down syndrome. A total of 158 pediatric patients (male = 95; female = 63; mean age 2.10 years, SD 3.17 years) received an initial VFSS at a pediatric teaching hospital as part of their medical care...
October 2016: Dysphagia
Guy E Boeckxstaens
Achalasia is a primary esophageal motility disorder with an estimated annual incidence of 1 per 100,000 persons. It is characterized by the absence of esophageal peristalsis and failure of the lower esophageal sphincter (LES) to relax upon swallowing, resulting in progressively severe dysphagia for solids and liquids, regurgitation, aspiration, chest pain and weight loss. Achalasia results from a loss of enteric neurons, most likely due to an autoimmune reaction in patients with a particular immunogenetic background...
2016: Digestive Diseases
Yue Lan, Guang-Qing Xu, Fan Yu, Tuo Lin, Li-Sheng Jiang, Feng Liu
OBJECTIVES/HYPOTHESIS: This study evaluated the effects of three levels of bolus consistency (water, thick liquid, and paste) on the nature and duration of physiologic pressure while swallowing in healthy adults using high-resolution manometry (HRM). STUDY DESIGN: A case series of healthy adults. METHODS: Thirty-four healthy young adults (mean age: 24.29 years) were instructed to swallow 3 mL and 10 mL of water, thick liquid, and paste material, respectively, during which the upper esophageal sphincter (UES) and pharyngeal pressures were measured by HRM...
June 14, 2016: Laryngoscope
Brittany N Krekeler, Nadine P Connor
OBJECTIVES/HYPOTHESIS: Aging results in progressive changes in deglutitive functions, which may be due in part to alterations in muscle morphology and physiology. Mastication is a critical component of bolus formation and swallowing, but aging effects on masticatory function have not been well studied. STUDY DESIGN: The purpose of this study was to 1) quantify the effects of aging on mastication, and 2) determine the effects of tongue exercise on mastication in young adult and old rats...
June 3, 2016: Laryngoscope
Hongmei Jiao, Ling Mei, Tarun Sharma, Mark Kern, Patrick Sanvanson, Reza Shaker
Oropharyngeal dysphagia due to upper esophageal sphincter (UES) dysfunction is commonly encountered in the clinical setting. Selective experimental perturbation of various components of the deglutitive apparatus can provide an opportunity to improve our understanding of the swallowing physiology and pathophysiology. The aim is to characterize the pharyngeal and UES deglutitive pressure phenomena in an experimentally induced restriction of UES opening in humans. We studied 14 volunteers without any dysphagic symptoms (7 men, 66 ± 11 yr) but with various supraesophageal reflux symptoms...
July 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
Johanna Savilampi, Taher Omari, Anders Magnuson, Rebecca Ahlstrand
BACKGROUND: Exposure to remifentanil increases the incidence of pulmonary aspiration in healthy volunteers. This effect may be explained by impairment of airway defence mechanisms and/or altered swallowing function. Pressure-flow analysis is a technique that allows objective assessment of swallowing based on pressure-impedance patterns recorded during bolus swallowing. OBJECTIVES: The aim of this study was to use pressure-flow analysis to quantify the effect of remifentanil on healthy pharyngeal swallowing and to compare these effects with morphine...
September 2016: European Journal of Anaesthesiology
Maggie-Lee Huckabee, Phoebe Macrae, Kristin Lamvik
Diagnostic assessment of swallowing in routine clinical practice relies heavily on the long-standing techniques of videofluoroscopic swallowing study (VFSS) and videoendoscopic evaluation of swallowing (VEES). These complementary and sophisticated techniques provide a real-time visualization of biomechanical movements of the structures involved in swallowing and consequent effects on bolus flow. Despite the sophistication of this instrumentation, interpretation relies heavily on subjective clinical judgement and temporal resolution is limited, limitations that may influence patient management...
2015: Folia Phoniatrica et Logopaedica
Robert T Kavitt, Ikuo Hirano, Michael F Vaezi
Eosinophilic esophagitis is a relatively recently discovered disease of increasing incidence and prevalence and is a common cause of dysphagia and food bolus impaction. The definition of eosinophilic esophagitis continues to evolve, most recently with the characterization of proton pump inhibitor-responsive esophageal eosinophilia. The number of high-quality prospective, controlled trials guiding therapeutic decisions in eosinophilic esophagitis has increased steadily over the past several years. Treatment options at present focus on dietary therapy, particularly implementation of a 6-food elimination diet, and medical therapy, primarily the use of swallowed, topical corticosteroids...
September 2016: American Journal of Medicine
S H Doeltgen, T I Omari, J Savilampi
Exposure to remifentanil contributes to an increased risk of pulmonary aspiration, likely through reduced pharyngeal contractile vigor and diminished bolus propulsion during swallowing. We employed a novel high-resolution pressure-flow analysis to quantify the biomechanical changes across the upper esophageal sphincter (UES). Eleven healthy young (23.3 ± 3.1 yr old) participants (7 men and 4 women) received remifentanil via intravenous target-controlled infusion with an effect-site concentration of 3 ng/ml...
June 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
Diane M Cheney, Stanley L Marks, Rachel E Pollard
Contrast videofluoroscopy is the gold standard procedure for evaluating dysphagia in humans, but quantitative measures vary depending on bolus size and consistency. We hypothesized that quantitative measures made during videofluoroscopy of swallowing in dogs would differ between bolus sizes and consistencies. Ten healthy adult dogs were enrolled a prospective, crossover experimental study and underwent contrast videofluoroscopy while swallowing liquid (5, 10, and 15 ml) and canned food (3, 8, and 12 g) boluses...
July 2016: Veterinary Radiology & Ultrasound
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