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Esophageal solid bolus transit: studies using concurrent videofluoroscopy and manometry.

P Pouderoux1, G Shi, R P Tatum

  • 1Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611-3053, USA.

The American Journal of Gastroenterology
|June 11, 1999
PubMed
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Solid food, like bread, is rarely cleared from the esophagus in one swallow. Chewing food and staying upright significantly improve solid bolus transit and esophageal clearance.

Area of Science:

  • Gastroenterology
  • Physiology
  • Swallowing Mechanics

Background:

  • Esophageal bolus transit is crucial for nutrient intake and preventing aspiration.
  • Liquid and solid bolus transport mechanisms may differ significantly.
  • Understanding factors influencing solid transit is key for diagnosing and managing dysphagia.

Purpose of the Study:

  • To investigate the efficacy and underlying mechanisms of solid bolus transit in the esophagus.
  • To compare esophageal clearance of liquid versus solid materials.
  • To evaluate the impact of posture and bolus preparation on solid transit.

Main Methods:

  • Concurrent manometry and videofluoroscopy were used in eight healthy volunteers.
  • Swallowing tasks included liquid barium, a bread ball, and chewed bread in supine and upright postures.

Related Experiment Videos

  • Multiple swallows were permitted for bolus clearance assessment.

    • Main Results:

    • Liquid barium achieved 100% clearance with the first swallow.
    • Unchewed bread clearance was significantly impaired, especially in the supine position (52.9% after four swallows).
    • Chewed bread demonstrated better clearance (100% upright, 91% supine after four swallows), with stasis often occurring at the aortic arch and carina.

    Conclusions:

    • Solid bolus clearance from the esophagus typically requires multiple swallows, unlike liquids.
    • Mastication and an upright posture significantly enhance esophageal transport of solids.
    • Peristaltic function is influenced by bolus composition and transit abnormalities, indicating liquid clearance data is not directly applicable to solids.