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Evaluating swallowing dysfunction using a 100-ml water swallowing test.

Meng-Chun Wu1, Yeun-Chung Chang, Tyng-Guey Wang

  • 1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.

Dysphagia
|January 28, 2004
PubMed
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The 100-ml water swallowing test (WST) shows swallowing speed is a sensitive indicator for dysphagia risk. Choking during the WST may specifically indicate aspiration, warranting further investigation.

Area of Science:

  • Clinical Medicine
  • Diagnostic Tools
  • Swallowing Disorders

Background:

  • Dysphagia assessment requires reliable and accessible methods.
  • Videofluoroscopic examination of swallowing (VFES) is a gold standard but resource-intensive.
  • The 100-ml water swallowing test (WST) offers a simpler alternative for initial screening.

Purpose of the Study:

  • To evaluate the diagnostic validity of the 100-ml WST against VFES.
  • To determine the effectiveness of swallowing speed and choking signs in identifying swallowing dysfunction.
  • To assess the WST's utility in detecting aspiration.

Main Methods:

  • Fifty-nine outpatients with suspected dysphagia underwent a 100-ml WST followed by VFES.
  • Swallowing speed (ml/s) and choking signs (coughing, wet-hoarse voice) were recorded during WST.

Related Experiment Videos

  • VFES data included aspiration and penetration events.

    • Main Results:

    • Swallowing speed < 10 ml/s in WST showed 85.5% sensitivity for dysphagia.
    • Choking during WST had 47.8% sensitivity but 91.7% specificity for aspiration.
    • 12 out of 45 participants without choking in WST still showed aspiration/penetration on VFES.

    Conclusions:

    • Swallowing speed in the 100-ml WST is a sensitive indicator for identifying patients at risk of swallowing dysfunction.
    • Choking or a wet-hoarse voice during the WST may be a specific indicator for potential aspiration.
    • The WST can aid in screening for dysphagia, but abnormal findings warrant further VFES evaluation.