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Dysphagia in bulimia nervosa

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Abstract

The findings on 13 patients with bulimia nervosa referred for evaluation of salivary glands and swallowing patterns are presented. Each patient completed a medical, oral, and social history questionnaire. A complete oral examination supported by appropriate dental radiographs and photographs was conducted. Unstimulated and stimulated parotid and submandibular saliva was collected. The presence or absence of pharyngeal and velar gag reflexes was ascertained. Real-time ultrasound scanning and barium swallow studies were used to evaluate the oral-motor functions while swallowing on 6 of the subjects. Activity of the pharynx, larynx, and esophagus was recorded during the videofluorographic studies. Saliva concentrations of amylase were determined in the referred subjects as well as 13 age-matched healthy controls. No significant difference was detected between the salivary gland flow rates and amylase concentrations of the two groups, whether stimulated or unstimulated. The pharyngeal gag reflex was absent in 9 of the 13 bulimic patients and a velar gag reflex could be elicited in only 1. All of the normal controls had both gag reflexes. All of the patients with bulimia were found to have abnormal oropharyngeal swallow patterns and an increased duration of dry swallow.

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References

  1. Herzog DB, Copeland PM: Eating disorders.N Engl J Med 313:295–303, 1985

    Article  CAS  PubMed  Google Scholar 

  2. Muuss RE: Adolescent eating disorder: bulimia.Adolescence 21:257–267, 1986

    CAS  PubMed  Google Scholar 

  3. Jones DJ, Fox MM, Babigian HM, et al.: Epidemiology of anorexia nervosa in Monroe County, New York: 1960–1976.Psychosom Med 42:551–558, 1980

    CAS  PubMed  Google Scholar 

  4. Garner DM, Garfinkel PE, Olmstead MP: An overview of sociocultural factors in the development of anorexia nervosa. In Darby PL, Garfinkel PE, Garner DM, et al. (eds):Anorexia Nervosa: Recent Developments in Research. New York: Alan R. Liss, 1983, pp 3–14

    Google Scholar 

  5. Casper RC, Eckert ED, Halmi KA: Bulimia: its incidence and clinical importance in patients with anorexia nervosa.Arch Gen Psychiatry 37:1030–1035, 1980

    CAS  PubMed  Google Scholar 

  6. Halmi KA, Casper RC, Eckert ED, et al.: Unique features associated with the age of onset of anorexia nervosa.Psychiatry Res 1:209–215, 1979

    Article  CAS  PubMed  Google Scholar 

  7. Hart KJ, Ollendick TH: The prevalence of bulimia in working and university women.Am J Psychiatry 142:851–854, 1985

    CAS  PubMed  Google Scholar 

  8. Schotte DE, Stunkard AJ: Bulimia vs bulimic behaviors on a college campus.JAMA 258:1213–1215, 1987

    Article  CAS  PubMed  Google Scholar 

  9. Johnson GL, Humphries LL, Shirley PB, et al.: Mitral valve prolapse in patients with anorexia nervosa and bulimia.Arch Intern Med 146:1525–1529, 1986

    Article  CAS  PubMed  Google Scholar 

  10. Adler AO, Walinsky P, Krall RA, et al.: Death resulting from ipecac syrup poisoning.JAMA 243:1927–1928, 1980

    Article  CAS  PubMed  Google Scholar 

  11. Kleier DJ, Aragon SB, Averback RE: Dental management of the chronic vomiting patient.J Am Dent Assoc 108:618–621, 1984

    CAS  PubMed  Google Scholar 

  12. Stege P, Vesco-Dangler L, Rye L: Anorexia nervosa: review including oral and dental manifestations.J Am Dent Assoc 104:648–652, 1982

    CAS  PubMed  Google Scholar 

  13. Roberts MW, Li S-H: Oral findings in anorexia and bulimia nervosa: a study of 47 cases.J Am Dent Assoc 115:407–410, 1987

    CAS  PubMed  Google Scholar 

  14. Brady JP: Parotid enlargement in bulimia.J Fam Pract 20:496–502, 1985

    CAS  PubMed  Google Scholar 

  15. Dawson J, Jones C: Vomiting-induced hypokalemic alkalosis and parotid swelling.Practitioner 218:267–268, 1977

    CAS  PubMed  Google Scholar 

  16. Levin PA, Falko JM, Dixon K, et al.: Benign parotid enlargement in bulimia.Ann Intern Med 93:827–829, 1980

    CAS  PubMed  Google Scholar 

  17. Katsilambros L: Asymptomatic enlargement of the parotid glands.JAMA 178:513–514, 1961

    CAS  PubMed  Google Scholar 

  18. Baum BJ, Bodner L, Fox PC, et al.: Therapy-induced dysfunction of salivary glands: implications for oral health.Spec Care Dent 5:274–277, 1985

    Article  CAS  Google Scholar 

  19. Tylenda CA, Ship JA, Fox PC, Baum BJ: Evaluation of submandibular salivary flow rate in different age groups.J Dent Res 67:1225–1228, 1988

    CAS  PubMed  Google Scholar 

  20. Hughes CV, Baum BJ, Fox PC, et al.: Oral-pharyngeal dysphagia: a common sequela of salivary gland dysfunction.Dysphagia 1:173–177, 1987

    Article  Google Scholar 

  21. Baum BJ: Evaluation of stimulated parotid saliva flow rate in different age groups.J Dent Res 60:1292–1296, 1981

    CAS  PubMed  Google Scholar 

  22. Shawker T, Sonies BC, Stone M, Baum BJ: Real-time ultrasonic visualization of tongue movement during swallowing.J Clin Ultrasound 11:485–494, 1983

    CAS  PubMed  Google Scholar 

  23. Sonies BC, Shawker TH, Baum BJ: Tongue motion in elderly adults: initial in situ observations.J Gerontol 39:279–283, 1984

    CAS  PubMed  Google Scholar 

  24. Sonies BC, Weiffenbach JM, Atkinson JC, Brahim JS, Macynski AA, Fox PC: Clinical examination of motor and sensory functions of the adult oral cavity.Dysphagia 1:178–186, 1987

    Article  Google Scholar 

  25. Shawker TH, Stone M, Sonies BC: Sonography of speech and swallow. In:Ultrasound Annual. New York: Raven Press, 1984

    Google Scholar 

  26. Sonies BC, Parent L, Morrish K, Baum BJ: Durational aspects of the oral-pharyngeal swallow in normal adults.Dysphagia 3:1–10, 1988

    Article  CAS  PubMed  Google Scholar 

  27. Boackle R, Suddick R: Salivary proteins and oral health. In Menanker L (ed):The Biologic Basis of Dental Caries. Harper & Row, Hagerstown/New York, 1980, pp 113–131

    Google Scholar 

  28. Kraus FW, Mestecky J: Immunohistochemical localization of amylase, lysozyme and immunoglobulins in the human parotid glands.Arch Oral Biol 16:781–789, 1971

    Article  CAS  PubMed  Google Scholar 

  29. Aguirre A, Levine MJ, Cohen RE, Tabak LA: Immunochemical quantitation of α-amylase and secretory IgA in parotid saliva from people of various ages.Arch Oral Biol 32:297–301, 1987

    Article  CAS  PubMed  Google Scholar 

  30. Squires B: Human salivary amylase secretion in relation to diet.J Physiol 49:153–156, 1953

    Google Scholar 

  31. Levin PA, Falko JM, Dixon K, Gallup EM, Saunders W: Benign parotid enlargement in bulimia.Ann Intern Med 93:827–829, 1980

    CAS  PubMed  Google Scholar 

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Roberts, M.W., Tylenda, C.A., Sonies, B.C. et al. Dysphagia in bulimia nervosa. Dysphagia 4, 106–111 (1989). https://doi.org/10.1007/BF02407154

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