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Sjögren’s syndrome patients may have swallowing dysfunction

20 Apr 2017

Patients with Sjögren’s syndrome (SS) appear to manifest symptoms such as dysphagia, with swallowing dysfunction substantially reducing the patient quality of life, a study has shown.

The study included 69 patients with SS (mean age 52.86 years; 94 percent female) and 40 healthy controls (mean age 48.25 years; 82.5 percent female).

Fiberoptic endoscopic evaluation of swallowing (FEES) was performed in all participants who were asked to complete a sequence of two swallows for each food consistency: 3 ml of water, 5 ml of yogurt and 10 ml of fish-shaped crackers. The presence of bolus control, residue, penetration and aspiration were evaluated. The MD Anderson Dysphagia Inventory and the Beck Depression Inventory was also administered to identify certain types of foods triggering the dysphagia, any difficulties in bolus control, need to clean the throat, sensation of having a lump in the throat, sensation of choking and xerostomia, as well as to assess the patient quality of life.

Results showed a significant difference in the presence of residue with yogurt and fish cracker between the SS and control groups (p<0.05). The presence of penetration was observed in two SS patients, but the difference was not significant (p>0.05).

Average score on the MD Anderson Dysphagia Inventory was worse in the SS group than in the control group (48.18 vs 87.6; p<0.05). A similar pattern of results was observed for the average score on the Beck Depression Inventory (11.83 in the SS group vs 8.03 in the control group; p<0.05).

The present data provide evidence of swallowing dysfunction and its association with lower quality of life and higher incidence of depression in SS patients, researchers said. “The presence of residue was [the] primary abnormality which affected the pharyngeal phase of swallowing in SS.”

Given the findings, dysphagia should be considered in the management of SS patients, they added. Treating the symptom may especially help avoid nutrition disorders in this population.

Characterized by salivary and lacrimal gland dysfunction causing dryness (sicca), SS is an autoimmune disease that affects up to 4 percent of the adult population and mostly women during midlife. Oropharyngeal and oesophageal swallowing disorders reported in this population have been attributed to sicca of the mouth and throat, loss of dentition, cricoarytenoid joint arthritis, neuropathy, oesophageal abnormalities and gastroesophageal reflux. [Dysphagia 2016;31:49–59]

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