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Eating and breathing: interactions between respiration and feeding on solid food
Jeffrey B Palmer1, Karen M Hiiemae
1Department of Physical Medicine and Rehabilitation, Johns Hopkins University and Good Samaritan Hospital, Baltimore, Maryland, USA. jpalmer@jhmi.edu
Dysphagia
|September 26, 2003
Summary
Preventing food aspiration during eating involves inhibiting respiration. Bolus formation in the pharynx typically occurs during a pause in breathing after active expiration, safeguarding the airway.
Area of Science:
- Physiology
- Swallowing biomechanics
- Respiratory regulation
Background:
- Solid food accumulates in the oropharynx before swallowing.
- The mechanism preventing aspiration during this phase is not fully understood.
- Respiration may play a role in airway protection during eating.
Purpose of the Study:
- To investigate the impact of eating, particularly pharyngeal bolus formation, on respiration.
- To elucidate the respiratory control mechanisms during the oropharyngeal phase of swallowing.
- To determine how chewing and bolus aggregation influence breathing patterns.
Main Methods:
- Simultaneous measurement of nasal air pressures, masseter electromyography (EMG), and videofluorography (VFG).
- Analysis of respiratory cycles (RCs) categorized as prefeeding, feeding, and swallowing.
- Evaluation of 8g banana and cookie boluses in four healthy adults.
Main Results:
- Swallowing RCs were significantly longer than feeding or prefeeding RCs.
- Bolus aggregation in the valleculae occurred during an extended nasal air pressure plateau post-expiration.
- Oronasal airflow was suggested during chewing via velopharyngeal isthmus activity.
Conclusions:
- Aspiration during eating is likely prevented by respiratory inhibition during pharyngeal bolus formation.
- The observed respiratory patterns support a protective mechanism during the vulnerable phase of food transit.
- Chewing and bolus preparation involve complex interplay between respiratory and oropharyngeal functions.