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Effect of Citric Acid and Citric Acid–Sucrose Mixtures on Swallowing in Neurogenic Oropharyngeal Dysphagia

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Abstract

The ability of sour and sweet–sour mixtures to improve swallowing in 11 nursing home residents with neurogenic oropharyngeal dysphagia was investigated using fiberoptic endoscopic evaluation of swallowing. Citric acid (2.7%) significantly reduced aspiration and penetration compared with water. Teaspoon delivery of liquids significantly reduced aspiration and penetration compared with natural cup drinking. Subjects tended to appropriately self-regulate the cup volume they consumed after the first trial. A significant increase in spontaneous dry swallows was observed after both taste stimuli. The mechanisms for improved swallowing due to citric acid are not understood but may be due to increased gustatory and trigeminal stimulation of acid to the brainstem in neurologically impaired subjects.

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Acknowledgements

We thank the nursing home administrators, staff, residents, and families who participated in this study. We are especially grateful to the nurses who assisted in the FEES procedures and to the anonymous reviewers for their helpful suggestions. Thanks also to Alina Prokopchuk for assistance in data collection, Karen Grace–Martin for statistical advice, and Joe Murray, Nancy Colodny, and especially Susan Hiss for their invaluable assistance and suggestions throughout the study.

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Authors and Affiliations

  1. Department of Food Science & Technology, Cornell University, Ithaca, New York, USA

    Cathy A. Pelletier PhD & Harry T. Lawless PhD

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  1. Cathy A. Pelletier PhD
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  2. Harry T. Lawless PhD
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Correspondence to Cathy A. Pelletier PhD.

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Pelletier, C.A., Lawless, H.T. Effect of Citric Acid and Citric Acid–Sucrose Mixtures on Swallowing in Neurogenic Oropharyngeal Dysphagia . Dysphagia 18, 231–241 (2003). https://doi.org/10.1007/s00455-003-0013-y

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