Jak rozpoznać zaburzenia połykania u osób ze stwardnieniem rozsianym? Artykuł przeglądowy
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Opublikowane:
mar 31, 2017
Słowa kluczowe:
stwardnienie rozsiane, powikłania, dysfagia, rozpoznanie, terapia
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Abstrakt
Zaburzenia połykania (dysfagia) pojawiają się u wielu chorych w przebiegu stwardnienia rozsianego (MS, multiple sclerosis). Możliwie wczesne rozpoznanie zaburzeń połykania jest bardzo ważne ze względu na wdrożenie odpowiedniego postępowania, ukierunkowanego na zapobieganie ich potencjalnie śmiertelnym powikłaniom i poprawę jakości życia chorych. We wczesnym rozpoznawaniu dysfagii w SM i monitorowaniu jej postępu mogą być przydatne kwestionariusze przesiewowe, m.in. DYMUS i EAT-10, lub testy przesiewowe, m.in. Dysphagia Limit. Pacjenci z objawami dysfagii powinni być poddani dalszej diagnostyce neurologopedycznej i w razie potrzeby badaniom instrumentalnym połykania. Główne strategie zapobiegające zapaleniu płuc, oprócz technik bezpiecznego jedzenia lub karmienia oraz modyfikacji diety, obejmują regularną higienę jamy ustnej i utrzymanie pozycji siedzącej po posiłkach. W celu zapobiegania niedożywieniu wskazane jest monitorowanie stanu odżywienia i w razie potrzeby wczesne wdrożenie leczenia żywieniowego oraz podjęcie decyzji o założeniu przezskórnej gastrostomii endoskopowej.
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Bibliografia
1. Bergamaschi R., Rezzani C., Minguzzi S. et al.: Validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. Funct. Neurol. 2009; 24(3): 159-162.
2. Guan X.L., Wang H., Huang H.S., Meng L.: Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurol. Sci. 2015; 36(5): 671-681.
3. Abraham S., Scheinberg L.C., Smith C.R., LaRocca N.G.: Neurologic Impairment and Disability Status in Outpatients with Multiple Sclerosis Reporting Dysphagia Symptomatology. Neurorehabil. Neural. Repair 1997; (11): 7-13.
4. Thomas F.J., Wiles C.M.: Dysphagia and nutritional status in multiple sclerosis. J. Neurol. 1999; 246(8): 677-82.
5. Poorjavad M., Derakhshandeh F., Etemadifar M. et al.: Oropharyngeal dysphagia in multiple sclerosis. Mult. Scler. 2010; 16(3): 362-365.
6. de Pauw A., Dejaeger E., D’hooghe B., Carton H.: Dysphagia in multiple sclerosis. Clin. Neurol. Neurosurg. 2002; 104(4): 345-351.
7. Prosiegel M., Schelling A., Wagner-Sonntag E.: Dysphagia and multiple sclerosis. Int. MS J. 2004; 11(1): 22-31.
8. Terre-Boliart R., Orient-Lopez F., Guevara-Espinosa D. et al.: [Oropharyngeal dysphagia in patients with multiple sclerosis]. Rev. Neurol. 2004; 39(8): 707-710.
9. Fernandes A.M., Duprat A.C., Eckley C.A. et al.: Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity? Braz. J. Otorhinolaryngol. 2013; 79(4): 460-465.
10. Calcagno P., Ruoppolo G., Grasso M.G. et al.: Dysphagia in multiple sclerosis – prevalence and prognostic factors. Acta Neurol. Scand. 2002; 105(1): 40-43.
11. Abraham S.S., Yun P.T.: Laryngopharyngeal dysmotility in multiple sclerosis. Dysphagia 2002; 17(1): 69-74.
12. Warnecke T., Dziewas R.: Neurogene Dysphagien. Diagnostik und Therapie. W. Kohlhammer GmbH, Stuttgart 2013.
13. Loser C.: Malnutrition in hospital: the clinical and economic implications. Dtsch Arztebl. Int. 2010; 107(51-52): 911-917.
14. Lim S.L., Ong K.C., Chan Y.H. et al.: Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin. Nutr. 2012; 31(3): 345-350.
15. Elia M.: The economics of malnutrition. Nestle Nutr. Workshop Ser. Clin. Perform Programme 2009; 12: 29-40.
16. Finestone H.M., Greene-Finestone L.S., Wilson E.S., Teasell R.W.: Malnutrition in stroke patients on the rehabilitation service and at follow-up: prevalence and predictors. Arch. Phys. Med. Rehabil. 1995; 76(4): 310-316.
17. Finestone H.M., Greene-Finestone L.S., Wilson E.S., Teasell R.W.: Prolonged length of stay and reduced functional improvement rate in malnourished stroke rehabilitation patients. Arch. Phys. Med. Rehabil. 1996; 77(4): 340-345.
18. Wiesner W., Wetzel S.G., Kappos L. et al.: Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms. Eur. Radiol. 2002; 12(4): 789-792.
19. Bergamaschi R., Crivelli P., Rezzani C. et al.: The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J. Neurol. Sci. 2008; 269(1-2): 49-53.
20. Alfonsi E., Bergamaschi R., Cosentino G. et al.: Electrophysiological patterns of oropharyngeal swallowing in multiple sclerosis. Clin. Neurophysiol. 2013; 124(8): 1638-1645.
21. Belafsky P.C., Mouadeb D.A., Rees C.J. et al.: Validity and reliability of the Eating Assessment Tool (EAT-10). Ann. Otol. Rhinol. Laryngol. 2008; 117(12): 919-924.
22. Cheney D.M., Siddiqui M.T., Litts J.K. et al.: The Ability of the 10-Item Eating Assessment Tool (EAT-10) to Predict Aspiration Risk in Persons With Dysphagia. Ann. Otol. Rhinol. Laryngol. 2015; 124(5): 351-354.
23. Rofes L., Arreola V., Mukherjee R., Clave P.: Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol. Motil. 2014; 26(9): 1256-1265.
24. Ertekin C., Aydogdu I., Yuceyar N.: Piecemeal deglutition and dysphagia limit in normal subjects and in patients with swallowing disorders. J. Neurol. Neurosurg. Psychiatry 1996; 61(5): 491-496.
25. Aydogdu I., Kiylioglu N., Tarlaci S. et al.: Diagnostic value of “dysphagia limit” for neurogenic dysphagia: 17 years of experience in 1278 adults. Clin. Neurophysiol. 2015; 126(3): 634-643.
26. Potulska A., Friedman A., Krolicki L., Spychala A.: Swallowing disorders in Parkinson’s disease. Parkinsonism Relat. Disord. 2003; 9(6): 349-353.
27. Trapl M., Enderle P., Nowotny M. et al.: Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 2007; 38(11): 2948-2952.
28. Simmons K.: Dysphagia management means diagnosis, exercise, reeducation. JAMA 1986; 255(23): 3209-3210, 3212.
29. Langmore S.E., Schatz K., Olsen N.: Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988; 2(4): 216-219.
30. Loser C., Aschl G., Hebuterne X. et al.: ESPEN guidelines on artificial enteral nutrition-percutaneous endoscopic gastrostomy (PEG). Clin. Nutr. 2005; 24(5): 848-861.
31. Tablan O.C., Anderson L.J., Besser R. et al.: Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm. Rep. 2004; 53(RR-3): 1-36.
32. Sorensen R.T., Rasmussen R.S., Overgaard K. et al.: Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J. Neurosci. Nurs. 2013; 45(3): 139-146.
33. Wagner C., Marchina S., Deveau J.A. et al.: Risk of Stroke-Associated Pneumonia and Oral Hygiene. Cerebrovasc. Dis. 2015; 41(1-2): 35-39.
34. Robertson T., Carter D.: Oral intensity: reducing non-ventilator-associated hospital-acquired pneumonia in care-dependent, neurologically impaired patients. Can. J. Neurosci. Nurs. 2013; 35(2): 10-17.
35. van der Maarel-Wierink C.D., Vanobbergen J.N., Bronkhorst E.M. et al.: Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology 2013; 30(1): 3-9.
36. Schmidt M. [Preventive measures in long-term nursing care of elderly patients: oral hygiene reduces risk of pneumonia]. Pflege Z. 2009; 62(11): 668-670.
37. Yamaya M., Yanai M., Ohrui T. et al.: Interventions to prevent pneumonia among older adults. J. Am. Geriatr. Soc. 2001; 49(1): 85-90.
38. Yoshida M., Yoneyama T., Akagawa Y.: [Oral care reduces pneumonia of elderly patients in nursing homes, irrespective of dentate or edentate status]. Nihon Ronen Igakkai Zasshi 2001; 38(4): 481-483.
39. Watando A., Ebihara S., Ebihara T. et al.: Daily oral care and cough reflex sensitivity in elderly nursing home patients. Chest 2004; 126(4): 1066-1070.
40. El-Solh A.A.: Association between pneumonia and oral care in nursing home residents. Lung 2011; 189(3): 173-180.
41. Orozco-Levi M., Torres A., Ferrer M. et al.: Semirecumbent position protects from pulmonary aspiration but not completely from gastroesophageal reflux in mechanically ventilated patients. Am. J. Respir. Crit. Care Med. 1995; 152(4 Pt 1): 1387-1390.
42. Drakulovic M.B., Torres A., Bauer T.T. et al.: Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet 1999; 354(9193): 1851-1858.
43. Wang L., Li X., Yang Z. et al.: Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation. Cochrane Database Syst. Rev. 2016; 1: CD009946.
44. Huang J.Y., Zhang D.Y., Yao Y. et al.: Training in swallowing prevents aspiration pneumonia in stroke patients with dysphagia. J. Int. Med. Res. 2006; 34(3): 303-306.
45. Steele C.M., Alsanei W.A., Ayanikalath S. et al.: The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia 2015; 30(1): 2-26.
2. Guan X.L., Wang H., Huang H.S., Meng L.: Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurol. Sci. 2015; 36(5): 671-681.
3. Abraham S., Scheinberg L.C., Smith C.R., LaRocca N.G.: Neurologic Impairment and Disability Status in Outpatients with Multiple Sclerosis Reporting Dysphagia Symptomatology. Neurorehabil. Neural. Repair 1997; (11): 7-13.
4. Thomas F.J., Wiles C.M.: Dysphagia and nutritional status in multiple sclerosis. J. Neurol. 1999; 246(8): 677-82.
5. Poorjavad M., Derakhshandeh F., Etemadifar M. et al.: Oropharyngeal dysphagia in multiple sclerosis. Mult. Scler. 2010; 16(3): 362-365.
6. de Pauw A., Dejaeger E., D’hooghe B., Carton H.: Dysphagia in multiple sclerosis. Clin. Neurol. Neurosurg. 2002; 104(4): 345-351.
7. Prosiegel M., Schelling A., Wagner-Sonntag E.: Dysphagia and multiple sclerosis. Int. MS J. 2004; 11(1): 22-31.
8. Terre-Boliart R., Orient-Lopez F., Guevara-Espinosa D. et al.: [Oropharyngeal dysphagia in patients with multiple sclerosis]. Rev. Neurol. 2004; 39(8): 707-710.
9. Fernandes A.M., Duprat A.C., Eckley C.A. et al.: Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity? Braz. J. Otorhinolaryngol. 2013; 79(4): 460-465.
10. Calcagno P., Ruoppolo G., Grasso M.G. et al.: Dysphagia in multiple sclerosis – prevalence and prognostic factors. Acta Neurol. Scand. 2002; 105(1): 40-43.
11. Abraham S.S., Yun P.T.: Laryngopharyngeal dysmotility in multiple sclerosis. Dysphagia 2002; 17(1): 69-74.
12. Warnecke T., Dziewas R.: Neurogene Dysphagien. Diagnostik und Therapie. W. Kohlhammer GmbH, Stuttgart 2013.
13. Loser C.: Malnutrition in hospital: the clinical and economic implications. Dtsch Arztebl. Int. 2010; 107(51-52): 911-917.
14. Lim S.L., Ong K.C., Chan Y.H. et al.: Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin. Nutr. 2012; 31(3): 345-350.
15. Elia M.: The economics of malnutrition. Nestle Nutr. Workshop Ser. Clin. Perform Programme 2009; 12: 29-40.
16. Finestone H.M., Greene-Finestone L.S., Wilson E.S., Teasell R.W.: Malnutrition in stroke patients on the rehabilitation service and at follow-up: prevalence and predictors. Arch. Phys. Med. Rehabil. 1995; 76(4): 310-316.
17. Finestone H.M., Greene-Finestone L.S., Wilson E.S., Teasell R.W.: Prolonged length of stay and reduced functional improvement rate in malnourished stroke rehabilitation patients. Arch. Phys. Med. Rehabil. 1996; 77(4): 340-345.
18. Wiesner W., Wetzel S.G., Kappos L. et al.: Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms. Eur. Radiol. 2002; 12(4): 789-792.
19. Bergamaschi R., Crivelli P., Rezzani C. et al.: The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J. Neurol. Sci. 2008; 269(1-2): 49-53.
20. Alfonsi E., Bergamaschi R., Cosentino G. et al.: Electrophysiological patterns of oropharyngeal swallowing in multiple sclerosis. Clin. Neurophysiol. 2013; 124(8): 1638-1645.
21. Belafsky P.C., Mouadeb D.A., Rees C.J. et al.: Validity and reliability of the Eating Assessment Tool (EAT-10). Ann. Otol. Rhinol. Laryngol. 2008; 117(12): 919-924.
22. Cheney D.M., Siddiqui M.T., Litts J.K. et al.: The Ability of the 10-Item Eating Assessment Tool (EAT-10) to Predict Aspiration Risk in Persons With Dysphagia. Ann. Otol. Rhinol. Laryngol. 2015; 124(5): 351-354.
23. Rofes L., Arreola V., Mukherjee R., Clave P.: Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol. Motil. 2014; 26(9): 1256-1265.
24. Ertekin C., Aydogdu I., Yuceyar N.: Piecemeal deglutition and dysphagia limit in normal subjects and in patients with swallowing disorders. J. Neurol. Neurosurg. Psychiatry 1996; 61(5): 491-496.
25. Aydogdu I., Kiylioglu N., Tarlaci S. et al.: Diagnostic value of “dysphagia limit” for neurogenic dysphagia: 17 years of experience in 1278 adults. Clin. Neurophysiol. 2015; 126(3): 634-643.
26. Potulska A., Friedman A., Krolicki L., Spychala A.: Swallowing disorders in Parkinson’s disease. Parkinsonism Relat. Disord. 2003; 9(6): 349-353.
27. Trapl M., Enderle P., Nowotny M. et al.: Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 2007; 38(11): 2948-2952.
28. Simmons K.: Dysphagia management means diagnosis, exercise, reeducation. JAMA 1986; 255(23): 3209-3210, 3212.
29. Langmore S.E., Schatz K., Olsen N.: Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988; 2(4): 216-219.
30. Loser C., Aschl G., Hebuterne X. et al.: ESPEN guidelines on artificial enteral nutrition-percutaneous endoscopic gastrostomy (PEG). Clin. Nutr. 2005; 24(5): 848-861.
31. Tablan O.C., Anderson L.J., Besser R. et al.: Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm. Rep. 2004; 53(RR-3): 1-36.
32. Sorensen R.T., Rasmussen R.S., Overgaard K. et al.: Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J. Neurosci. Nurs. 2013; 45(3): 139-146.
33. Wagner C., Marchina S., Deveau J.A. et al.: Risk of Stroke-Associated Pneumonia and Oral Hygiene. Cerebrovasc. Dis. 2015; 41(1-2): 35-39.
34. Robertson T., Carter D.: Oral intensity: reducing non-ventilator-associated hospital-acquired pneumonia in care-dependent, neurologically impaired patients. Can. J. Neurosci. Nurs. 2013; 35(2): 10-17.
35. van der Maarel-Wierink C.D., Vanobbergen J.N., Bronkhorst E.M. et al.: Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology 2013; 30(1): 3-9.
36. Schmidt M. [Preventive measures in long-term nursing care of elderly patients: oral hygiene reduces risk of pneumonia]. Pflege Z. 2009; 62(11): 668-670.
37. Yamaya M., Yanai M., Ohrui T. et al.: Interventions to prevent pneumonia among older adults. J. Am. Geriatr. Soc. 2001; 49(1): 85-90.
38. Yoshida M., Yoneyama T., Akagawa Y.: [Oral care reduces pneumonia of elderly patients in nursing homes, irrespective of dentate or edentate status]. Nihon Ronen Igakkai Zasshi 2001; 38(4): 481-483.
39. Watando A., Ebihara S., Ebihara T. et al.: Daily oral care and cough reflex sensitivity in elderly nursing home patients. Chest 2004; 126(4): 1066-1070.
40. El-Solh A.A.: Association between pneumonia and oral care in nursing home residents. Lung 2011; 189(3): 173-180.
41. Orozco-Levi M., Torres A., Ferrer M. et al.: Semirecumbent position protects from pulmonary aspiration but not completely from gastroesophageal reflux in mechanically ventilated patients. Am. J. Respir. Crit. Care Med. 1995; 152(4 Pt 1): 1387-1390.
42. Drakulovic M.B., Torres A., Bauer T.T. et al.: Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet 1999; 354(9193): 1851-1858.
43. Wang L., Li X., Yang Z. et al.: Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation. Cochrane Database Syst. Rev. 2016; 1: CD009946.
44. Huang J.Y., Zhang D.Y., Yao Y. et al.: Training in swallowing prevents aspiration pneumonia in stroke patients with dysphagia. J. Int. Med. Res. 2006; 34(3): 303-306.
45. Steele C.M., Alsanei W.A., Ayanikalath S. et al.: The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia 2015; 30(1): 2-26.