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Verma H, Kumar S, Sharma A, Mishra R, Nagamani B. Swallowing dysfunction between the community-living older adults with and without comorbid conditions using Patient-Reported Outcome Measures (PROM). Geriatr Nurs 2024; 56:64-73. [PMID: 38301436 DOI: 10.1016/j.gerinurse.2023.12.020] [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: 09/29/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The present study aimed to investigate older adults' perspective on their swallowing physiology using a PROM tool. The study further explored the swallowing issues among older adults with and without comorbid conditions. METHOD One hundred twenty-two (122) participants participated in the e-survey. A questionnaire was developed to assess the swallowing deficits among older adults, and Eating Assessment Tool-10 (EAT-10) was administered to assess the PROM. RESULTS The results revealed that 40% of older adults with comorbid conditions had EAT-10 scores greater than 3, suggesting swallowing deficits. A significant difference was observed between the two groups with respect to swallowing deficits, as reported on EAT-10. CONCLUSION Based on the results, it can be delineated that swallowing deficits emerge with aging. More of older adults with comorbid conditions reported swallowing deficits in comparison to those without comorbid conditions. Hence, their nutritional and health status gets compromised, leading to poor quality of life.
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Affiliation(s)
- Himanshu Verma
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sourabh Kumar
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Atul Sharma
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Roshani Mishra
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Banumathy Nagamani
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Niu C, Zhang J, Bapaye J, Liu H, Zhu K, Farooq U, Zahid S, Zhang Q, Boppana H, Elkhapery A, Okolo PI. Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic Patients. Am J Gastroenterol 2023; 118:2123-2132. [PMID: 37463432 DOI: 10.14309/ajg.0000000000002410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION We aimed to conduct a systematic review and meta-analysis to assess the impact of chronic opioid exposure on esophageal motility in patients undergoing manometric evaluation. METHODS Multiple databases were searched through October 2022 for original studies comparing the manometric results of patients who have used chronic opioids (for >90 days) with those who do not. The primary outcomes were esophageal dysmotility disorders. Three high-resolution manometry parameters were conducted as secondary outcomes. A random-effects model was applied to calculate the odds ratio (OR) and means difference (MD) along with a 95% confidence interval (CI). RESULTS Nine studies were included in this meta-analysis. Opioid use was associated with higher esophageal dysmotility disorders, including distal esophageal spasm (pooled OR 4.84, 95% CI 1.60-14.63, P = 0.005, I 2 = 96%), esophagogastric junction outflow obstruction (pooled OR 5.13, 95% CI 2.11-12.43, P = 0.0003, I 2 = 93%), and type III achalasia (pooled OR 4.15, 95% CI 2.15-8.03, P < 0.0001, I 2 = 64%). No significant differences were observed for hypercontractile esophagus, type I achalasia, or type II achalasia. The basal lower esophageal sphincter pressure (MD 3.02, 95% CI 1.55-4.50, P < 0.0001, I 2 = 90%), integrated relaxation pressure (MD 2.51, 95% CI 1.56-3.46, P < 0.00001, I 2 = 99%), and distal contractile integral (MD 640.29, 95% CI 469.56-811.03, P < 0.00001, I 2 = 91%) significantly differed between the opioid use and nonopioid use group. However, opioid use was associated with a lower risk of ineffective esophageal motility (pooled OR 0.68, 95% CI 0.49-0.95, P = 0.02, I 2 = 53%). DISCUSSION Chronic opioid exposure is associated with an increased frequency esophageal dysmotility disorders. Our results revealed that opioid use is significantly associated with type III achalasia but not with type I and II achalasia. Therefore, opioid treatment should be taken into account as a potential underlying risk factor when diagnosing these major esophageal motor abnormalities.
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Affiliation(s)
- Chengu Niu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Jing Zhang
- Harbin Medical University, Harbin, China
| | - Jay Bapaye
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Hongli Liu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Kaiwen Zhu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Umer Farooq
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Salman Zahid
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Qian Zhang
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Hemanth Boppana
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Ahmed Elkhapery
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Patrick I Okolo
- Division of Gastroenterology, Rochester General Hospital, Rochester, New York, USA
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Abstract
This paper is the forty-second consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2019 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd., Flushing, NY, 11367, United States.
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Murray FR, Fischbach LM, Schindler V, Schnurre L, Hente JM, Tatu A, Pohl D. Solid Swallow Examination During High Resolution Manometry and EGJ-Distensibility Help Identify Esophageal Outflow Obstruction in Non-obstructive Dysphagia. Dysphagia 2021; 37:168-176. [PMID: 33609164 PMCID: PMC8843924 DOI: 10.1007/s00455-021-10260-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/27/2021] [Indexed: 12/02/2022]
Abstract
Single water swallow (SWS) high-resolution manometry (HRM) may miss relevant esophageal motility disorders. Solid test meal (STM) during HRM and lately the functional lumen imaging probe (FLIP) have been shown to be of diagnostic value in the assessment of motility disorders. We aimed to assess the diagnostic yield of STM and FLIP in non-obstructive dysphagia (NOD). Patients assessed for dysphagia with both HRM and FLIP between April 2016 and August 2019 were analyzed for signs of non-obstructive EGJ outflow obstruction (EGJOO) according to Chicago Classification 3.0 (CCv3) and CC adapted for the use with solid swallows (CC-S), followed by an individual group-specific analysis. Five subjects without dysphagia served as control group. Standard HRM- and FLIP-values as well as esophagograms and Eckardt Scores were analyzed. Forty-two patients were identified (male/female, 14/36, median age 62). Twenty-five (59.5%) were diagnosed with EGJOO during STM only (= SWS-negative patients; CC-S). The EGJ distensibility index (EGJ-DI) of symptomatic patients was significantly lower compared to the control group (p = 0.006). EGJ-DI was < 3mm2/mmHg in 67% and 88% of patients diagnosed according to CC-S and CCv3, respectively. The IRP during STM showed a significant association to the corresponding EGJ-DI values (p < 0.001). Seventy-six percent of patients received treatment because of additional STM evaluation with a favorable clinical response rate of 89%. STM and FLIP identify EGJOO in symptomatic patients with normal SWS during HRM. STM resembles an inexpensive and clinically meaningful option to diagnose motility disorders and helps to select patients for interventional treatment.
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Affiliation(s)
- Fritz Ruprecht Murray
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Lara Maria Fischbach
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Valeria Schindler
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Larissa Schnurre
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Juliane Marie Hente
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Aurora Tatu
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Daniel Pohl
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
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Alcala-González LG, Jimenez-Masip A, Relea Pérez L, Barber-Caselles C, Barba-Orozco E. Opioid-induce esophageal dysfunction, prevalence and manometric findings. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 114:16-21. [PMID: 33486967 DOI: 10.17235/reed.2021.7598/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Prescription opioids usage is on the rise. There has been an increasing recognition that chronic opioid consumption can result in esophageal motility disorders and this association has been named opioid-induced esophageal dysfunction (OIED). AIMS Analyze the prevalence of chronic opioid consumption in patients referred for esophageal motility testing in a European center and to describe the clinical characteristics and the association of opioid consumption in esophageal motility disorders. METHODS Retrospective descriptive study in patients who had HRM performed in a single center. The clinical history in the electronic medical reports was reviewed. RESULTS The prevalence of opioid prescription in patients referred to our institution was 10.1% and 4.8% patients were on active chronic opioid use. We found a 32% prevalence of OIED. Comparing chronic active opioid user (CAOU) patients with OIED and CAOU patients without OIED, there was a higher prevalence of male sex (43.8% vs 8.8% p value=0.007). Converting the different opioids medication to morphine milligram equivalent daily dose (MMED), CAOU patients with OIED had a higher MMED than CAOU patients without OIED (125.2±31.3 vs 33.4±5.7 MME p=0.041). Dysphagia was the most common indication for performing an HRM in 60.0% in CAOU patients. Furthermore, dysphagia was more frequent in CAOU patients with OIED (87.5% vs 47.0% p= 0.019). CONCLUSIONS Patients on chronic opioids with OIED complained mostly dysphagia. We found an association of male sex and a higher dose of opioids in CAOU patients with esophageal motility disorders.
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Vázquez García P, Ciriza de Los Ríos C, Canga Rodríguez-Valcárcel F, Hernández García-Gallardo D. Progression of Jackhammer Esophagus to Type III Achalasia and Improvement After Extended Myotomy. J Neurogastroenterol Motil 2020; 26:164-166. [PMID: 31917918 PMCID: PMC6955194 DOI: 10.5056/jnm19156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Pablo Vázquez García
- Digestive Motility Unit, Department of Gastroenterology and Hepatology, 12 de Octubre University Hospital, Madrid, Spain
| | - Constanza Ciriza de Los Ríos
- Digestive Motility Unit, Department of Gastroenterology and Hepatology, 12 de Octubre University Hospital, Madrid, Spain
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Kim GH, Jung KW. The Role of Opioids and Alcohol in the Development of Achalasia Type III and Esophagogastric Junction Outflow Obstruction. J Neurogastroenterol Motil 2019; 25:177-178. [PMID: 30982237 PMCID: PMC6474699 DOI: 10.5056/jnm19047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/14/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Ga Hee Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea
| | - Kee Wook Jung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea
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