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Martins FLPDSP, Inete MB, Souza YDDES, Costa RLV, Gabbay RD, Moraes TM, Costa VVL, Paracampo CCP, de Albuquerque LC, Gomes DL. Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery. Nutrients 2024; 16:1096. [PMID: 38674787 PMCID: PMC11054139 DOI: 10.3390/nu16081096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 04/28/2024] Open
Abstract
Given the changes in the digestive tract post-bariatric surgery, adapting to a new pattern of eating behavior becomes crucial, with special attention to the specifics of chewing mechanics. This study aimed to investigate the association between self-perception of chewing, chewing behavior, and the presence of gastrointestinal symptoms in preoperative patients undergoing bariatric surgery. Sixty adult candidates for bariatric surgery at a public hospital in Belém (Brazil) were analyzed. Participants predominantly exhibited unilateral chewing patterns (91.6%), a fast chewing rhythm (73.3%), a large food bolus (80%), liquid intake during meals (36.7%), and 41.7% reported that chewing could cause some issue. Significant associations were found between the perception of causing problems and chewing scarcity (p = 0.006), diarrhea (p = 0.004), absence of slow chewing (p = 0.048), and frequent cutting of food with front teeth (p = 0.034). These findings reveal a relationship between the perception of chewing problems and chewing scarcity, presence of diarrhea, and fast chewing.
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Affiliation(s)
- Flávia Luciana Pinheiro de Souza Pinto Martins
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Millena Borges Inete
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Yasmym Dannielle do Espírito Santo Souza
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Rafaela Lorena Viana Costa
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Rafaelle Dias Gabbay
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Tainá Martins Moraes
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | | | - Carla Cristina Paiva Paracampo
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Luiz Carlos de Albuquerque
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
| | - Daniela Lopes Gomes
- Graduate Program in Neuroscience and Behavior, Behavior Theory and Research Center, Federal University of Pará, Belém 66075-110, Brazil; (F.L.P.d.S.P.M.); (M.B.I.); (Y.D.d.E.S.S.); (R.L.V.C.); (R.D.G.); (T.M.M.); (C.C.P.P.); (L.C.d.A.)
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Wang Y, Zhu K, Wang N, Chen X, Cai C, Zhu Y, Shi C. Development and Validation of a Risk Prediction Model to Predict Postextubation Dysphagia in Elderly Patients After Endotracheal Intubation Under General Anesthesia: A Single-Center Cross-Sectional Study. Dysphagia 2024; 39:63-76. [PMID: 37272948 DOI: 10.1007/s00455-023-10594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
At present, the incidence and risk factors for dysphagia after extubation in elderly inpatients are still unclear, and we aimed to develop and validate a risk prediction model that prospectively identifies high-risk patients to reduce the occurrence rate of dysphagia. The 469 patients recruited were randomly divided into modeling and validation groups in a 7:3 ratio. In the modeling group, the postextubation dysphagia (PED) risk factors were analyzed, and a risk prediction model was established. In the validation group, the model was validated and evaluated. The model was constructed based on the risk factors determined by a binary logistic regression analysis. The discrimination ability of the model was evaluated by the receiver operating characteristic (ROC) curve. The calibration curve and Hosmer‒Lemeshow test were performed to evaluate the model's calibration ability. The clinical utility of the risk prediction model was analyzed by decision curve analysis (DCA). The results showed that the incidence of PED was 15.99%, and age, duration of indwelling gastric tube, difficult endotracheal intubation, atomization after extubation, anesthesia risk level and frailty assessment were identified as important risk factors. The model was validated to have favorable discrimination, calibration ability and clinical utility. It has a certain extension value and clinical applicability, providing a feasible reference for preventing the occurrence of PED.
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Affiliation(s)
- Yixin Wang
- Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, China
| | - Kaimei Zhu
- Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Nan Wang
- Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, China
| | - Xiangrong Chen
- General Hospital of PLA Central Theater Command, Wuhan, Hubei, China
| | - Chan Cai
- Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, China
| | - Yuxin Zhu
- Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, China
| | - Chongqing Shi
- Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, China.
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Kuze LS, Fornari F, Collares K, Della Bona A. Association between masticatory dysfunction and gastroesophageal reflux disease: A population-based study in the elderly. J Oral Rehabil 2023; 50:150-156. [PMID: 36478604 DOI: 10.1111/joor.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Caries and periodontal disease may cause tooth losses and chewing difficulty, especially in the elderly. Ingesting poorly chewed food may delay gastric emptying and favour the development of gastroesophageal reflux disease (GERD). OBJECTIVE This study investigated the association between masticatory dysfunction and GERD in the elderly from a rural area in southern Brazil. METHODS This census invited all 489 elderly from a city to participate. The study used a GERD symptoms questionnaire, followed by an oral examination. Masticatory dysfunction was analysed based on the chewing difficulty for some food groups. Tooth loss and chewing self-perception were also considered as exposure variables. Poisson regression determined the association among variables by calculating the prevalence ratio [PR (95% confidence interval)]. RESULTS The response rate was 93.1% (n = 455, average age of 70.9 years, 50.5% men). The prevalence of GERD in this population was 36.9%. GERD was associated with chewing difficulty for vegetables (PR = 1.54), meats (PR = 1.34) and cereals (PR = 1.43) but not with poor chewing self-perception (PR = 0.80) and tooth loss (PR = 1.22). GERD was also associated with xerostomia (PR = 1.63) and the female gender (PR = 1.35). CONCLUSION Elderly people from a rural area with a reduced number of teeth present chewing difficulty and a high prevalence of GERD, indicating an association between GERD and masticatory dysfunction.
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Affiliation(s)
- Luana Soares Kuze
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
| | - Fernando Fornari
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
| | - Kauê Collares
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
| | - Alvaro Della Bona
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
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Pauletti RN, Callegari-Jacques SM, Fornari L, Moraes ID, Fornari F. Reduced mastication is a risk factor for Rome IV postprandial distress syndrome in patients investigated with upper endoscopy. Clin Res Hepatol Gastroenterol 2022; 46:102032. [PMID: 36244614 DOI: 10.1016/j.clinre.2022.102032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/27/2022] [Accepted: 10/10/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Reduced mastication could force the stomach to do extra work on crushing food and contribute to dyspeptic symptoms. This study aimed to assess the relationship between mastication and dyspepsia. METHODS This cross-sectional study involved 209 consecutive patients referred for elective upper endoscopy. Before endoscopy, an expert dentist performed an oral examination and scored chewing function in three levels (normal, regular, and reduced), and applied questionnaires for assessment of dyspepsia (Rome IV), xerostomia, and mastication (normal, regular, and reduced). A reduced masticatory function was defined when an oral examination or mastication questionnaire rated the chewing as poor. Associations between mastication, confounders, and dyspepsia were estimated by prevalence ratio [PR (95% Confidence Interval)] using Poisson regression. RESULTS Thirty-four patients showed relevant organic conditions in the upper gastrointestinal tract (moderate to severe reflux oesophagitis, peptic ulcer, neoplasia, and surgical modification) and were excluded. Among 175 patients with non-organic diseases (aging 51.3 ± 15.7 years; 61.7% women), 50 (28.6%) had reduced mastication, and 125 (71.4%) had normal/regular mastication. After adjusting for age and xerostomia, reduced mastication was associated with postprandial distress syndrome [PR = 1.93 (95%CI 1.27 - 2.91)] but not with epigastric pain syndrome [PR = 1.09 (95%CI 0.75 - 1.60)]. CONCLUSIONS In patients referred for upper digestive endoscopy, reduced mastication was associated with postprandial distress syndrome but not with epigastric pain syndrome. An interdisciplinary approach with dentists and physicians might benefit dyspeptic patients with postprandial distress syndrome.
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Affiliation(s)
- Roberta Neuwald Pauletti
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade de Passo Fundo (UPF), Passo Fundo-RS, Brazil
| | | | | | | | - Fernando Fornari
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade de Passo Fundo (UPF), Passo Fundo-RS, Brazil; Faculdade de Medicina, UPF, Passo Fundo, Brazil; Clínica Endopasso, Passo Fundo, Brazil.
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