Jou Janice, Radowsky Jason, Gangnon Ronald, Sadowski Elizabeth, Kays Stephanie, Hind Jacqueline, Gaumnitz Eric, Taylor Andrew, Robbins Joanne
Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
Gastroenterol Res Pract. 2009;2009:965062. doi: 10.1155/2009/965062. Epub 2009 Sep 23.
Normal esophageal bolus transport in asymptomatic healthy older adults has not been well defined, potentially leading to ambiguity in differentiating esophageal swallowing patterns of dysphagic and healthy individuals. This pilot study of 24 young (45-64 years) and old (65+years) men and women was designed to assess radiographic esophageal bolus movement patterns in healthy adults using videofluoroscopic recording. Healthy, asymptomatic adults underwent videofluoroscopic esophagram to evaluate for the presence of ineffective esophageal clearance, namely, intraesophageal stasis and intraesophageal reflux. Intraesophageal stasis and intraesophageal reflux were visualized radiographically in these normal subjects. Intraesophageal stasis occurred significantly more frequently with semisolid (96%) compared with liquid (16%) barium, suggesting that a variety of barium consistencies, as opposed to only the traditional fluids, would better define the spectrum of esophageal transport. Intraesophageal reflux was observed more frequently in older males than in their younger counterparts. The rates of intraesophageal stasis and intraesophageal reflux were potentially high given that successive bolus presentations were spaced 10 seconds apart. These findings suggest a need for a more comprehensive definition regarding the range of normal esophageal bolus transport to (a) prevent misdiagnosis of dysphagia and (b) to enhance generalization to functional eating, which involves solid foods in addition to liquids.
无症状健康老年人的正常食管团块运输尚未得到很好的界定，这可能导致在区分吞咽困难个体和健康个体的食管吞咽模式时产生歧义。这项针对24名年轻（45 - 64岁）和老年（65岁及以上）男性和女性的初步研究旨在通过视频荧光记录评估健康成年人的放射影像学食管团块运动模式。健康、无症状的成年人接受了视频荧光食管造影，以评估是否存在无效食管清除，即食管内淤滞和食管内反流。在这些正常受试者中，通过放射影像学观察到了食管内淤滞和食管内反流。与液体（16%）钡剂相比，半固体（96%）钡剂导致食管内淤滞的发生率显著更高，这表明与仅使用传统液体相比，多种钡剂稠度能更好地界定食管运输的范围。老年男性比年轻男性更频繁地观察到食管内反流。鉴于连续团块呈现间隔为10秒，食管内淤滞和食管内反流的发生率可能较高。这些发现表明需要对正常食管团块运输范围进行更全面的定义，以（a）防止吞咽困难的误诊，以及（b）增强对功能性进食的推广，功能性进食除了液体外还涉及固体食物。
