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Elicitation of the Swallowing Reflex by Esophageal Stimulation in Healthy Subjects: An Evaluation Using High-Resolution Manometry.

Authors
  • Taniguchi, Hiroshige1, 2
  • Aoyagi, Yoichiro3
  • Matsuo, Koichiro1
  • Imaeda, Sayuri4
  • Hirumuta, Makoto5
  • Saitoh, Eiichi6
  • 1 Department of Dentistry & Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan. , (Japan)
  • 2 Department of Dentistry for the Disability and Oral Health, School of Dentistry, Asahi University, Mizuho, Japan. , (Japan)
  • 3 Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan. [email protected] , (Japan)
  • 4 Faculty of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan. , (Japan)
  • 5 Faculty of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan. , (Japan)
  • 6 Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan. , (Japan)
Type
Published Article
Journal
Dysphagia
Publication Date
Oct 19, 2019
Identifiers
DOI: 10.1007/s00455-019-10068-z
PMID: 31630249
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The purposes of this human study using high-resolution manometry were to verify whether the swallowing reflex can be evoked by intra-esophageal fluid injection and whether the reflex latency and manometric variables differ depending on the injected location, amount, or speed. Ten healthy individuals participated in this study. The tip of the intranasal catheter for injection was placed at 5 cm (upper), 10 cm (upper-middle), 15 cm (lower-middle), or 20 cm (lower) from the distal end of the upper esophageal sphincter (UES). An intra-esophageal injection of 3 mL or 10 mL of thickened water was administered and controlled at 3 mL/s or 10 mL/s. Latencies from the start of the injection to the onset of UES relaxation were compared regarding injection locations, amounts, and rates. Manometric variables of intra-esophageal injection and voluntary swallowing were compared. The latency became shorter when the upper region was injected. Latency after the 10-mL injection was shorter than that after the 3-mL injection (p < 0.01) when faster injection (10 mL/s) was used. Faster injection induced shorter latency (p < 0.01) when a larger volume (10 mL) was injected. Pre-maximum and post-maximum UES pressures during voluntary swallowing or during spontaneous swallowing when injecting the upper esophageal region were significantly higher than spontaneous swallowing at other regions (p < 0.01). Intra-esophageal fluid injection induces the swallowing reflex in humans. The most effective condition for inducing the swallowing reflex involved a larger fluid amount with a faster injection rate in the upper esophagus.

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