Clinical and etiological characterization of a sample of children and adults with dysphagia treated in two healthcare centers in Medellín/Colombia: a retrospective study
DOI:
https://doi.org/10.17533/10.17533/udea.iatreia.138Keywords:
Deglutition, Deglutition Disorders, Etiology, Neurologic ManifestationsAbstract
Introduction: Dysphagia is a frequent disorder throughout the life cycle, which has different etiologies
in relation to its clinical type in oropharyngeal or esophageal.
Objective: Clinical and etiological characterization of a sample with dysphagia attended in two health care
centers in the city of Medellín (Colombia), showing the etiology and clinical type of dysphagia according to age groups.
Methods: Observational, descriptive, and retrospective study, through the review and analysis of and clinical records of patients with a diagnosis of dysphagia, treated between 2012 and 2018 in a university hospital and a speech therapy center in swallowing.
Results: Sample of 527 patients. Distributed in those under 18 years 45.4% (239/527); 18 to 59: 20.1%(106/527) and over 60: 34.5% (182/527). Clinical type, etiology, and most frequent health condition in the entire sample: oropharyngeal dysphagia, functional etiology, and neurological diseases. The most frequent conditions causing dysphagia in children under 18 years of age were childhood evelopment disorders; group 18 to 59 years, cancer and, in those over 60 years of age, neurodegenerative
processes.
Conclusion: Oropharyngeal dysphagia due to functional etiology is common throughout the life cycle, and neurological diseases seem to largely explain its pathophysiology. In older adults it is associated with neurodegenerative disorders, and in those under 60 years of age (including children) the etiology is diverse. Its causes and clinical characteristics must be considered for promotion, diagnosis, treatment, and rehabilitation processes.
Downloads
References
(1) López-Liria R, Fernández-Alonso M, Vega-Ramírez FA, Salido-Campos MÁ, Padilla-Góngora D. Tratamiento y rehabilitación de la disfagia tras enfermedad cerebrovascular [Treatment and rehabilitation of dysphagia following cerebrovascular disease]. Rev Neurol. 2014 Mar 16;58(6):259-67. DOI 10.33588/rn.5806.2013335.
(2) Hirano I, Kahrilas PJ. Dysphagia. En: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editores. Harrison’s Principles of Internal Medicine. 20a ed [Internet]. New York: McGraw-Hill Education; 2018. [Consultado 2019 ene]. Disponible en: https://bit.ly/2W5FtRs
(3) Barrett KE. Esophageal Motility. En: Gastrointestinal Physiology. 2a ed [Internet]. New York: The McGraw-Hill Companies; 2014. [Consultado 2019 ene 9]. Disponible en: https://bit.ly/3xR03Tz
(4) Granieri E. Nutrition and the older adult. Dysphagia. 1990;4(4):196-201. DOI 10.1007/BF02407265.
(5) Jones B. Abnormalities of Pharyngeal Function. In: Gore RM, Levine MS, editors. Textbook of Gastrointestinal Radiology. Philadelphia: Saunders; 2015. p. 222-36.
(6) Hirano I, Kahrilas PJ. Dysphagia. En: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editores. Harrison’s Principles of Internal Medicine. 19a ed [Internet]. New York: McGraw-Hill Education; 2015. [Consultado 2018 mar 27]. Disponible en: https://bit.ly/36RFoTG
(7) Clavé P, Arreola V, Velasco M, Quer M, Castellví JM, Almirall J, et al. Diagnosis and treatment of functional oropharyngeal dysphagia. Features of interest to the digestive surgeon. Cir Esp. 2007 Aug;82(2):62-76. DOI 10.1016/s0009-739x(07)71672-x.
(8) Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999 Feb;116(2):455-78. DOI 10.1016/s0016-5085(99)70144-7.
(9) Daroff RB, Fenichel GM, Jankovic J, Mazziotta J, Bradley WG. Bradley’s Neurology in Clinical Practice, 2-Volume Set [internet]. EE. UU: Elsevier; 2015. [Consultado 2018 mar 27]. Disponible en: https://bit.ly/3zjYTQO.
(10) Approach to the evaluation of dysphagia in adults [Internet]. Philadelphia: Wolters Kluwer Health; [citado el 27 de marzo de 2018]. Disponible en: https://bit.ly/3k3rpjM.
(11) Giraldo-Cadavid LF, Gutiérrez-Achury AM, Ruales-Suárez K, Rengifo-Varona ML, Barros C, Posada A, et al. Validation of the Spanish Version of the Eating Assessment Tool-10 (EAT-10spa) in Colombia. A Blinded Prospective Cohort Study. Dysphagia. 2016 Jun;31(3):398-406. DOI 10.1007/s00455-016-9690-1.
(12) Langmore SE, Grillone G, Elackattu A, Walsh M. Disordersof swallowing: palliative care. Otolaryngol Clin North Am. 2009 Feb;42(1):87-105,ix. DOI 10.1016/j.otc.2008.09.005.
(13) Clavé P, Terré R, de Kraa M, Serra M. Approaching oropharyngeal dysphagia. Rev Esp Enferm Dig. 2004 Feb;96(2):119-31. DOI 10.4321/s1130-01082004000200005.
(14) Kertscher B, Speyer R, Fong E, Georgiou AM, Smith M. Prevalence of oropharyngeal dysphagia in the Netherlands: a telephone survey. Dysphagia. 2015 Apr;30(2):114-20. DOI 10.1007/s00455-014-9584-z.
(15) Cook IJ. Oropharyngeal dysphagia. Gastroenterol Clin North Am. 2009 Sep;38(3):411-31. DOI 10.1016/j.gtc.2009.06.003.
(16) Carnaby-Mann G, Lenius K. The bedside examination in dysphagia. Phys Med Rehabil Clin N Am. 2008 Nov;19(4):747-68,viii. DOI 10.1016/j.pmr.2008.05.008.
(17) González-Fernández M, Ottenstein L, Atanelov L, Christian AB. Dysphagia after Stroke: an Overview. Curr Phys Med Rehabil Rep. 2013 Sep;1(3):187-196. DOI 10.1007/s40141-013-0017-y.
(18) Espitalier F, Fanous A, Aviv J, Bassiouny S, Desuter G, Nerurkar N, et al. International consensus (ICON) on assessment of oropharyngeal dysphagia. Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1S):S17-S21. DOI 10.1016/j.anorl.2017.12.009.
(19) Garon BR, Sierzant T, Ormiston C. Silent aspiration: results of 2,000 video fluoroscopic evaluations. J Neurosci Nurs. 2009 Aug;41(4):178-85; quiz 186-7. DOI 10.1097/JNN.0b013e3181aaaade.
(20) Ramsey DJC, Smithard DG, Kalra L. Early assessments of dysphagia and aspiration risk in acute stroke patients. Stroke. 2003 May;34(5):1252-7. DOI 10.1161/01.STR.0000066309.06490.B8.
(21) Fattori B, Giusti P, Mancini V, Grosso M, Barillari MR, Bastiani L, et al. Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia. Acta Otorhinolaryngol Ital. 2016 Oct;36(5):395-402. DOI 10.14639/0392-100X-829.
(22) Suárez-Escudero JC, Rueda Vallejo ZV, Orozco AF. Disfagia y neurología: ¿una unión indefectible? Acta Neurológica Colombiana. marzo de 2018;34(1):92–100. DOI 10.22379/24224022184.
(23) Carod-Artal FJ. Neurological rehabilitation and continuity of care after stroke. Neurologia. 2011 Apr;26(3):190. DOI 10.1016/j.nrl.2010.07.026.
(24) Salazar OF, Serna D, Múnera A, Mejía MMM, Álvarez P, Cornejo JW, et al. Características clínicas y videofluoroscópicas de la disfagia orofaríngea en niños entre un mes y cinco años de vida. Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 2004. Iatreia. 2008;21(1):13-20.
(25) Hincapié Henao L, Elena Lugo L, Daniel Ortiz S, Eugenia López M. Prevalencia de disfagia en unidad de cuidados especiales. Revista CES Med (Colombia). 2010;24(2):21–9.
(26) ais.paho.org [Internet]. Washington: Pan American Health Organzation; [citado el 30 de abril de 2020]. Disponible en: https://ais.paho.org/classifications/Chapters/
(27) Cho SY, Choung RS, Saito YA, Schleck CD, Zinsmeister AR, Locke GR, et al. Prevalence and risk factors for dysphagia: a USA community study. Neurogastroenterol Motil. 2015 Feb;27(2):212-9. DOI 10.1111/nmo.12467.
(28) Eslick GD, Talley NJ. Dysphagia: epidemiology, risk factors and impact on quality of life--a population-based study. Aliment Pharmacol Ther. 2008 May;27(10):971-9. DOI 10.1111/j.1365-2036.2008.03664.x.
(29) Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. Dysphagia. 1991;6(4):187-92. DOI 10.1007/BF02493524.
(30) Aydogdu I, Kiylioglu N, Tarlaci S, Tanriverdi Z, Alpaydin S, Acarer A, et al. Diagnostic value of “dysphagia limit” for neurogenic dysphagia: 17 years of experience in 1278 adults. Clin Neurophysiol. 2015 Mar;126(3):634-43. DOI 10.1016/j.clinph.2014.06.035.
(31) Morgan AT, Mageandran SD, Mei C. Incidence and clinical presentation of dysarthria and dysphagia in the acute setting following paediatric traumatic brain injury. Child Care Health Dev. 2010 Jan;36(1):44-53. DOI 10.1111/j.1365-2214.2009.00961.x.
(32) Buswell CA, Leslie P, Embleton ND, Drinnan MJ. Oralmotor dysfunction at 10 months corrected gestational age in infants born less than 37 weeks preterm. Dysphagia. 2009 Mar;24(1):20-5. DOI 10.1007/s00455-008-9161-4.
(33) American Speech-Language-Hearing Association [Internet]. Rockville: adult dysphagia;[citado 2018 27 mar]. Disponible en: https://bit.ly/3mfo4R5
(34) Britton D, Roeske A, Ennis SK, Benditt JO, Quinn C, Graville D. Utility of Pulse Oximetry to Detect Aspiration: An Evidence-Based Systematic Review. Dysphagia. 2018 Jun;33(3):282-292. DOI 10.1007/s00455-017-9868-1.
(35) Suttrup I, Warnecke T. Dysphagia in Parkinson’s Disease. Dysphagia. 2016 Feb;31(1):24-32. DOI 10.1007/s00455-015-9671-9.
(36) García Romero R, Ros Arnal I, Romea Montañés MJ, López Calahorra JA, Gutiérrez Alonso C, Izquierdo Hernández B, et al. Evaluation of dysphagia. Results after one year of incorporating videofluoroscopy into its study. An Pediatr (Barc). 2018 Aug;89(2):92-97. DOI 10.1016/j.anpedi.2017.07.009.
(37) Tjaden K. Speech and Swallowing in Parkinson’s Disease. Top Geriatr Rehabil. 2008;24(2):115-126. DOI 10.1097/01.TGR.0000318899.87690.44.
(38) Alagiakrishnan K, Bhanji RA, Kurian M. Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review. Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):1-9. DOI 10.1016/j.archger.2012.04.011.
(39) Geeganage C, Beavan J, Ellender S, Bath PMW. Interventions for dysphagia and nutritional support in acute and subacute stroke. Cochrane Database Syst Rev. 2012 Oct 17;10:CD000323. DOI 10.1002/14651858.CD000323.pub2.
(40) Cherney LR, Halper AS. Swallowing problems in adults with traumatic brain injury. Semin Neurol. 1996 Dec;16(4):349-53. DOI 10.1055/s-2008-1040993.
(41) Bhattacharyya N. The prevalence of dysphagia among adults in the United States. Otolaryngol Head Neck Surg. 2014 Nov;151(5):765-9. DOI 10.1177/0194599814549156.
(42) Frías Ordóñez JS, Martínez Marín JD. Características de la disfagia en pacientes de un centro de gastroenterología en Bogotá D. C., Colombia. Revista Colombiana de Gastroenterologia. diciembre de 2018;33(4):372–8. DOI 10.22516/25007440.212.
(43) Calis EA, Veugelers R, Sheppard JJ, Tibboel D, Evenhuis HM, Penning C. Dysphagia in children with severe generalized cerebral palsy and intellectual disability. Dev Med Child Neurol. 2008 Aug;50(8):625-30. DOI 10.1111/j.1469-8749.2008.03047.x.
(44) Lawlor CM, Choi S. Diagnosis and Management of Pediatric Dysphagia: A Review. JAMA Otolaryngol Head Neck Surg. 2020 Feb 1;146(2):183-191. DOI 10.1001/jamaoto.2019.3622.
(45) Navarro D, Nogales A, Rossell A, López K, Candelario E, Materan V, et al. Experiencia en la evaluación diagnóstica y terapéutica de la disfagia orofaríngea y esofágica en niños. Gen. 2014;68(3):80–4.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Universidad de Antioquia
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Papers published in the journal are available for use under the Creative Commons license, specifically Attribution-NonCommercial-ShareAlike 4.0 International.
The papers must be unpublished and sent exclusively to the Journal Iatreia; the author uploading the contribution is required to submit two fully completed formats: article submission and authorship responsibility.