Skip to main content

Advertisement

SpringerLink
Log in

Oral and pharyngeal bolus transit in gastroesophageal reflux disease

  • Original Article
  • Published:
Esophagus Aims and scope Submit manuscript

Abstract

Background

Gastroesophageal reflux disease (GERD) is a cause of dysphagia. Our aim in this investigation was to evaluate the duration of the oral and pharyngeal transit in patients with GERD, with the hypothesis that these patients may have an alteration of oral–pharyngeal transit.

Method

The swallow of 31 patients with GERD, 27 with erosive esophagitis, 15 with mild dysphagia for solid foods, and 26 controls was evaluated by the videofluoroscopic method. Controls and patients swallowed in duplicate 5 and 10 mL boluses of liquid and paste consistency.

Results

Transit was longer in patients with GERD than controls through the upper esophageal sphincter with 5 mL liquid bolus [controls: 0.39 (0.10) s, GERD: 0.47 (0.21) s, p = 0.01], through the mouth and from mouth to esophagus with 10 mL liquid bolus, and through the pharynx, and upper esophageal sphincter [0.45 (0.11) s, GERD: 0.51 (0.26) s, p = 0.01] with 10 mL paste bolus. In patients with erosive esophagitis and dysphagia, the duration of transit through the upper esophageal sphincter was longer in patients than in controls. Such difference was not seen when the upper esophageal sphincter transit duration of patients with erosive esophagitis without dysphagia was compared with controls. There was no bolus aspiration into the airway in any subject. Pharyngeal residues were seen in the same proportion of patients and controls.

Conclusion

Swallowed bolus flow through the upper esophageal sphincter of patients with GERD is slower than that seen in normal volunteers, mainly in patients with erosive disease associated with dysphagia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yuksel ES, Vaezi MF. Extraesophageal manifestations of gastroesophageal reflux disease: cough, asthma, laryngitis, chest pain. Swiss Med Wkly. 2012;142:w13544.

    Google Scholar 

  2. Richter JE. The many manifestations of gastroesophageal reflux disease: presentation evaluation and treatment. Gastroenterol Clin N Am. 2007;36:577–99.

    Article  Google Scholar 

  3. Eslick GD, Talley NJ. Dysphagia: epidemiology, risk factors and impact on quality o life—a population-based study. Alim Pharmacol Ther. 2008;27:971–9.

    Article  CAS  Google Scholar 

  4. Vakil NB, Traxler B, Levine D. Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment. Clin Gastroenterol Hepatol. 2004;2:665–8.

    Article  CAS  PubMed  Google Scholar 

  5. Lazarescu A, Karamanolis G, Aprile R, Oliveira RB, Dantas R, Sifrim D. Perception of dysphagia: lack of correlation with objective measurements of esophageal function. Neurogastroenterol Motil. 2010;22:1292–7.

    Article  CAS  PubMed  Google Scholar 

  6. Lang IM. Brain stem control of the phases of swallowing. Dysphagia. 2009;24:333–48.

    Article  PubMed  Google Scholar 

  7. Massey BT. Pathological pharyngo-esophageal interactions. Dysphagia. 1995;10:232–4.

    Article  CAS  PubMed  Google Scholar 

  8. Triadafilopoulos G, Hallstone A, Nelson-Abbott H, Bedinger K. Oropharyngeal and esophageal interrelationships in patients with nonobstructive dysphagia. Dig Dis Sci. 1992;37:551–7.

    Article  CAS  PubMed  Google Scholar 

  9. Santos CM, Cassiani RA, Dantas RO. Videofluoroscopic evaluation of swallowing in Chagas’ disease. Dysphagia. 2011;26:361–5.

    Article  PubMed  Google Scholar 

  10. Jones B, Ravich WJ, Donner MW, Kramer SS, Hendrix TR. Pharyngoesophageal interrelationships: observations and working concepts. Gastrointest Radiol. 1985;10:225–33.

    Article  CAS  PubMed  Google Scholar 

  11. Cherry J, Siegel CI, Margulis SI, Donner MW. Pharyngeal localization of symptoms of gastroesophageal reflux. Ann Otol Rhinol Laryngol. 1970;79:912–4.

    Article  CAS  PubMed  Google Scholar 

  12. Bredenoord AJ, Pandolfino JE, Smout AJPM. Gastro-oesophageal reflux disease. Lancet. 2013;381:1933–42.

    Article  PubMed  Google Scholar 

  13. Mendell DA, Logemann JA. A retrospective analysis of the pharyngeal swallow in patients with clinical diagnosis of GERD compared with normal controls: a pilot study. Dysphagia. 2002;17:220–6.

    Article  PubMed  Google Scholar 

  14. White RJ, Morris GP, Paterson WG. Impairment of deglutition reflex by acid-induced esophageal mucosal injury. Dig Dis Sci. 2001;46:802–7.

    Article  CAS  PubMed  Google Scholar 

  15. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmich JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of Los Angeles classification. Gut. 1999;45:172–80.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Leite LP, Johnston BT, Barrett J, Castell JA, Castell DO. Ineffective esophageal motility (IEM). The primary finding in patients with nonspecific esophageal motility disorder. Dig Dis Sci. 1997;42:1859–65.

    Article  CAS  PubMed  Google Scholar 

  17. Schall R. Estimation in generalized linear models with random effects. Biometrika. 1991;78:719–27.

    Article  Google Scholar 

  18. Littell RC, Milliken GA, Stroup WW, Wolfinger RD. SAS system of non-linear mixed models. Cary: SAS Institute Inc.; 1996.

    Google Scholar 

  19. Kidambi T, Toto E, Ho N, Taft T, Hirano I. Temporal trends in the relative prevalence of dysphagia in reflux esophagitis. World J Gastroenterol. 2012;18:4335–41.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Triadafilopoulos G. Nonobstructive dysphagia in reflux esophagitis. Am J Gastroenterol. 1989;84:614–8.

    CAS  PubMed  Google Scholar 

  21. Buthpitiya AG, Stroud D, Russell COH. Pharyngeal pump and esophageal transit. Dig Dis Sci. 1987;32:1244–8.

    Article  CAS  PubMed  Google Scholar 

  22. Yoshikawa H, Kuruta K, Ueno M, Egawa M, Yoshino A, Kondo S, et al. Oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function. J Gastroenterol. 2012;47:412–20.

    Article  PubMed  Google Scholar 

  23. Koç H, Vinyard CJ, Essick GK, Foegeding EA. Food oral processing: conversion of food structure to textual perception. Annu Rev Food Sci Technol. 2013;4:237–66.

    Article  PubMed  Google Scholar 

  24. Dantas RO, Aprile LRO. Esophageal striated muscle contractions in patients with gastroesophageal reflux symptoms. Dig Dis Sci. 2002;47:2586–90.

    Article  PubMed  Google Scholar 

  25. Szczesniak MM, Fuentealba SE, Cook IJ. Acid sensitization of esophageal mucosa afferents: implication for symptom perception in patients across the gastroesophageal reflux disease spectrum. Clin J Pain. 2013;29:70–7.

    Article  PubMed  Google Scholar 

  26. Savarino E, Gemignani L, Pohl D, Zentilin P, Dulbecco P, Assandri L, et al. Oesophageal motility and bolus transit abnormalities increase in parallel with severity of gastro-oesophageal relux disease. Alim Pharmacol Ther. 2011;34:476–86.

    Article  CAS  Google Scholar 

  27. Alkan T, Demir A, Yigit O, Adatepe T, Kesici B, Kocak I, et al. Cricopharyngeal muscle electromyography findings in patients with gastroesophgaeal reflux disease. Otolaryngol Head Neck Surg. 2012;147:295–301.

    Article  PubMed  Google Scholar 

  28. Alves LMT, Secaf M, Dantas RO. Oral, pharyngeal, and esophageal transit of an acidic bolus in healthy subjects. Esophagus. 2013;10:217–22.

    Article  Google Scholar 

  29. Shaw SM, Martino R. The normal swallow. Muscular and neurophysiologic control. Otolaryngol Clin N Am. 2013;46:937–56.

    Article  Google Scholar 

  30. Madanick RD. Proton pump inhibitor side effects and drug interations: much ado about nothing? Cleve Clin J Med. 2011;78:39–49.

    Article  PubMed  Google Scholar 

Download references

Ethical Statement

All procedures followed in this investigation were in concordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

There is no conflict of interest for Rachel A Cassiani, Gustavo A Mota, and Roberto O Dantas.

Author information

Authors and Affiliations

  1. Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil

    Rachel Aguiar Cassiani & Roberto Oliveira Dantas

  2. Department of Surgery, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil

    Gustavo Assis Mota

  3. Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil

    Roberto Oliveira Dantas

Authors
  1. Rachel Aguiar Cassiani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gustavo Assis Mota
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberto Oliveira Dantas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roberto Oliveira Dantas.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cassiani, R.A., Mota, G.A. & Dantas, R.O. Oral and pharyngeal bolus transit in gastroesophageal reflux disease. Esophagus 12, 345–351 (2015). https://doi.org/10.1007/s10388-014-0481-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10388-014-0481-1

Keywords

Search

Navigation