[Role of gastro-esophageal reflux (GER) and swallowing latency in aspiration pulmonary diseases].
We evaluated the role of gastro-esophageal reflux (GER) in aspiration pulmonary disease. To explore swallowing function, we measured the latent time (LT) on the swallowing provocation test in patient with non-aspiration pneumonia (PN, n=5), aspiration pneumonia (AP, n=8), post-gastrectomy aspiration pneumonia (PGAP, n=8), gastro-esophageal reflux disease (GERD, n=12) and normal group (NR, n=7). LT was prolonged in the AP (2.83 +/- 1.66 sec p < 0.01), PGAP (2.58 +/- 1.40 sec p < 0.05) and GERD (2.40 +/- 1.70 sec p < 0.05) groups compared with NR (1.04 +/- 0.56 sec) group, but not prolonged in PN (1.46 +/- 0.75 sec) group. LT was also prolonged when swallowing was provoked during inspiration both in AP (3.61 +/- 2.60 sec vs. 2.73 +/- 2.19 sec, p < 0.05) and NR (2.13 -/+ 1.12 sec vs. 1.49 +/- 1.30 sec, p < 0.01). Protected specimen brushing (PSB) was employed to detect pathogenic organisms in the PN (n=70), AP (AP, n=27) and PGAP (n=15) groups. Gram-negative rods were most frequently detected in the PGAP (p=0.008) group. We conclude that GER plays an important role in aspiration pulmonary disease not only as a source of aspirating agent but also as a disturbing factor of swallowing function.
Department of Internal Medicine, Tokyo Metropolitan Police Hospital.
Kazuyoshi
K
Marumo
Shoko
S
Homma
D000328:Adult; D000368:Aged; D003679:Deglutition / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000150:complications*; D011930:Reaction Time / Q000502:physiology*; D012307:Risk Factors