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Esophageal dysphagia and reflux symptoms before and after oral IQoro(R) training
Hudiksvall Hospital, Sweden; Uppsala University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Norrköping.
2015 (English)In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 21, no 24, 7558-7562 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To examine whether muscle training with an oral IQoro(R) screen (IQS) improves esophageal dysphagia and reflux symptoms. METHODS: A total of 43 adult patients (21 women and 22 men) were consecutively referred to a swallowing center for the treatment and investigation of long-lasting nonstenotic esophageal dysphagia. Hiatal hernia was confirmed by radiologic examination in 21 patients before enrollment in the study (group A; median age 52 years, range: 19-85 years). No hiatal hernia was detected by radiologic examination in the remaining 22 patients (group B; median age 57 years, range: 22-85 years). Before and after training with an oral IQS for 6-8 mo, the patients were evaluated using a symptom questionnaire (esophageal dysphagia and acid chest symptoms; score 0-3), visual analogue scale (ability to swallow food: score 0-100), lip force test (greater than= 15 N), velopharyngeal closure test (greater than= 10 s), orofacial motor tests, and an oral sensory test. Another twelve patients (median age 53 years, range: 22-68 years) with hiatal hernia were evaluated using oral IQS traction maneuvers with pressure recordings of the upper esophageal sphincter and hiatus canal as assessed by high-resolution manometry. RESULTS: Esophageal dysphagia was present in all 43 patients at entry, and 98% of patients showed improvement after IQS training [mean score (range): 2.5 (1-3) vs 0.9 (0-2), P less than 0.001]. Symptoms of reflux were reported before training in 86% of the patients who showed improvement at follow-up [1.7 (0-3) vs 0.5 (0-2), P less than 0.001). The visual analogue scale scores were classified as pathologic in all 43 patients, and 100% showed improvement after IQS training [71 (30-100) vs 22 (0-50), P less than 0.001]. No significant difference in symptom frequency was found between groups A and B before or after IQS training. The lip force test [31 N (12-80 N) vs 54 N (27-116), P less than 0.001] and velopharyngeal closure test values [28 s (5-74 s) vs 34 s (13-80 s), P less than 0.001] were significantly higher after IQS training. The oral IQS traction results showed an increase in mean pressure in the diaphragmatic hiatus region from 0 mmHg at rest (range: 0-0 mmHG) to 65 mmHg (range: 20-100 mmHg). CONCLUSION: Oral IQS training can relieve/improve esophageal dysphagia and reflux symptoms in adults, likely due to improved hiatal competence.

Place, publisher, year, edition, pages
Baishideng Publishing Group Co. Limited , 2015. Vol. 21, no 24, 7558-7562 p.
Keyword [en]
Esophageal dysphagia; Manometry; Muscle training; Oral screen; Reflux
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-120225DOI: 10.3748/wjg.v21.i24.7558ISI: 000356924900024PubMedID: 26140003OAI: oai:DiVA.org:liu-120225DiVA: diva2:842654
Note

Funding Agencies|Centre for Research and Development, Uppsala University/County Council of Gavleborg, Gavle, Sweden; Council for Regional Research in Uppsala and Orebro, Sweden

Available from: 2015-07-21 Created: 2015-07-20 Last updated: 2015-07-21

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Franzen, Thomas
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesDepartment of Surgery in LinköpingDivision of Clinical SciencesFaculty of Health SciencesDepartment of Surgery in Norrköping
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World Journal of Gastroenterology
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