POSTFUNDOPLICATION DYSPHAGIA CAUSES SIMILAR WATER INGESTION DYNAMICS AS ACHALASIA.
BACKGROUND
- After surgical treatment of gastroesophageal reflux disease dysphagia is a symptom in the majority of patients, with decrease in intensity over time. However, some patients may have persistent dysphagia.


OBJECTIVE
- The objective of this investigation was to evaluate the dynamics of water ingestion in patients with postfundoplication dysphagia compared with patients with dysphagia caused by achalasia, idiopathic or consequent to Chagas' disease, and controls.


METHODS
- Thirty-three patients with postfundoplication dysphagia, assessed more than one year after surgery, together with 50 patients with Chagas' disease, 27 patients with idiopathic achalasia and 88 controls were all evaluated by the water swallow test. They drunk, in triplicate, 50 mL of water without breaks while being precisely timed and the number of swallows counted. Also measured was: (a) inter-swallows interval - the time to complete the task, divided by the number of swallows during the task; (b) swallowing flow - volume drunk divided by the time taken; (c) volume of each swallow - volume drunk divided by the number of swallows.


RESULTS
- Patients with postfundoplication dysphagia, Chagas' disease and idiopathic achalasia took longer to ingest all the volume, had an increased number of swallows, an increase in interval between swallows, a decrease in swallowing flow and a decrease in water volume of each swallow compared with the controls. There was no difference between the three groups of patients. There was no correlation between postfundoplication time and the results.


CONCLUSIONS
- It was concluded that patients with postfundoplication dysphagia have similar water ingestion dynamics as patients with achalasia.
Departamento de Clinica Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto SP, Brasil., Universidade de São Paulo, Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP , Brazil.
Roberto Oliveira
RO
Dantas
Departamento de Clinica Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto SP, Brasil., Universidade de São Paulo, Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP , Brazil.
Carla Manfredi
CM
Santos
Departamento de Clinica Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto SP, Brasil., Universidade de São Paulo, Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP , Brazil.
Rachel Aguiar
RA
Cassiani
Departamento de Clinica Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto SP, Brasil., Universidade de São Paulo, Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP , Brazil.
Leda Maria Tavares
LM
Alves
Departamento de Clinica Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto SP, Brasil., Universidade de São Paulo, Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP , Brazil.
Weslania Viviane
WV
Nascimento
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D014355:Chagas Disease / Q000503:physiopathology*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004326:Drinking; D060766:Drinking Water; D004931:Esophageal Achalasia / Q000503:physiopathology*; D005260:Female; D018662:Fundoplication / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged
D060766:Drinking Water