Higher risk of complications in odynophagia-associated dysphagia in amyotrophic lateral sclerosis

Luchesi, Karen Fontes; Kitamura, Satoshi; Mourão, Lucia Figueiredo

doi:10.1590/0004-282X20130244

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Sumário

Articles • Arq. Neuro-Psiquiatr. 72 (3) • Mar 2014 • https://doi.org/10.1590/0004-282X20130244 copy

Higher risk of complications in odynophagia-associated dysphagia in amyotrophic lateral sclerosis

Disfagia associada à odinofagia na esclerose lateral amiotrófica pode sugerir maior risco para complicações pulmonares e nutricionais

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

This investigation aimed to identify associated factors with dysphagia severity in amyotrophic lateral sclerosis (ALS).

Method

We performed a cross-sectional study of 49 patients with ALS. All patients underwent fiberoptic endoscopy evaluation of swallowing and answered a verbal questionnaire about swallowing complaints. The patients were divided into groups according to dysphagia severity.

Results

Among the factors analyzed, only odynophagia was associated with moderate or severe dysphagia.

Conclusion

Odynophagia was associated with moderate and severe dysphagia in ALS and suggests a high risk of pulmonary and nutritional complications.

amyotrophic lateral sclerosis; dysphagia; neurodegenerative disorders; malnutrition; pneumonia; pain

	Group 1: Normal swallowing and mild dysphagia (n=25)	Group 2: Moderate and severe dysphagia (n=24)
	Mean (±SD^a)	Mean (±SD^a)
Gender (male/female)	13/12	14/10
Age at symptoms’ onset (years)	52.1 (±10.5)	52.7 (±9.6)
Age at first assessment (years)	54.4 (±11)	55 (±9.2)
Disease duration (years)	2.29 (±1.8)	2.2 (±1.5)
Swallowing complaints (n)	5.6 (±4)	10 (±2)
Swallowing complaints in oral phase (n)	2.6 (±2.5)	4.8 (±2)
Swallowing complaints in pharyngeal phase (n)	3 (±2)	5 (±3)

Complaints	Group 1: Normal swallowing and mild dysphagia (n=25)	Group 2: Moderate and severe dysphagia (n=24)
	n (%)	n (%)
Labial food escape	10 (40.0)	16 (66.6)
Chewing difficulty	13 (52.0)	17 (70.8)
Palatal food residues	12 (48.0)	13 (54.1)
Difficulty in ejecting the bolus	10 (40.0)	20 (83.3)
Food residue in the oral cavity	12 (48.0)	17 (70.8)
Labial escape of liquid or saliva	13 (52.0)	17 (70.8)
Difficulty in swallowing saliva	4 (16.0)	4 (16.6)

Complaints	Group 1: Normal swallowing and mild dysphagia (n=25)	Group 2: Moderate and severe dysphagia (n=24)
	n (%)	n (%)
Nasal reflux	5 (20.0)	7 (29.1)
Coughing	4 (16.0)	4 (16.6)
Gagging	16 (64.0)	22 (91.6)
Throat clearing	14 (56.0)	16 (66.6)
Sensation of food stasis	19 (76.0)	16 (66.6)
Painful swallowing (odynophagia)	9 (36.0)	22 (91.6)
Swallowing difficulties	11 (44.0)	16 (66.6)
Swallowing delays	2 (8.0)	3 (12.5)

Variables	Prevalence	Confidence Interval	p-value
Swallowing complaints in oral phase (n)	1.38	1.08–1.75	0.009
Swallowing complaints in pharyngeal phase (n)	1.20	1.01–1.43	0.03
Difficulty in ejecting the bolus (yes × no)	3.16	1.08–9.26	0.03
Painful swallowing (odynophagia) (yes × no)	6.38	1.50–27.16	0.01

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[1] Correspondence:
Karen Fontes Luchesi, Centro de Estudos e Pesquisas em Reabilitação, Faculdade de Ciências Médicas, Universidade Estadual de Campinas; Av. Tessália Vieira de Camargo, 126 – Cidade Universitária; 13083-887 Campinas SP – Brasil; E-mail: karenluchesi@yahoo.com.br .