Oral and pharyngeal bolus transit in gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a cause of dysphagia. Our aim in this investigation was to evaluate the duration of the oral and pharyngeal transit in patients with GERD, with the hypothesis that these patients may have an alteration of oral–pharyngeal transit.

The swallow of 31 patients with GERD, 27 with erosive esophagitis, 15 with mild dysphagia for solid foods, and 26 controls was evaluated by the videofluoroscopic method. Controls and patients swallowed in duplicate 5 and 10 mL boluses of liquid and paste consistency.

Transit was longer in patients with GERD than controls through the upper esophageal sphincter with 5 mL liquid bolus [controls: 0.39 (0.10) s, GERD: 0.47 (0.21) s, p = 0.01], through the mouth and from mouth to esophagus with 10 mL liquid bolus, and through the pharynx, and upper esophageal sphincter [0.45 (0.11) s, GERD: 0.51 (0.26) s, p = 0.01] with 10 mL paste bolus. In patients with erosive esophagitis and dysphagia, the duration of transit through the upper esophageal sphincter was longer in patients than in controls. Such difference was not seen when the upper esophageal sphincter transit duration of patients with erosive esophagitis without dysphagia was compared with controls. There was no bolus aspiration into the airway in any subject. Pharyngeal residues were seen in the same proportion of patients and controls.

Swallowed bolus flow through the upper esophageal sphincter of patients with GERD is slower than that seen in normal volunteers, mainly in patients with erosive disease associated with dysphagia.