Oropharyngeal swallowing pathophysiology in patients with idiopathic pulmonary fibrosis: A consecutive descriptive case series

Abstract

Introduction: Research into swallowing dysfunction (dysphagia) in IPF is limited. Dysphagia is seen in other respiratory conditions such as COPD, increasing the risk of pulmonary complications secondary to aspiration. Aim: Explore the oropharyngeal swallow of IPF patients. Methods: Ten consecutive IPF patients from the Newcastle Interstitial Lung Disease clinic were recruited. Each had videofluoroscopy, and were given measured amounts of food and drink. Videofluoroscopies were analysed using validated scales: Penetration-Aspiration Scale (PAS); Modified Barium Swallow Impairment Profile (MBSImP). Results: Seven males, three females, mean age 66 (52-78) were recruited. Three had airway penetration. One aspirated liquid without a cough response. Mean MBSImp for oral impairment was 4 (95%CI 4-4) and pharyngeal impairment 8.3 (95%CI 5.6–11.0), indicating mild alterations to swallowing physiology. Method: Videofluoroscopy indicating accumulation of Barium-labelled liquid in oropharyngeal cavity with penetration (arrowed) in IPF patient. Conclusion: To our knowledge, this is the first report on Swallowing Pathophysiology in IPF. We believe a proportion of this group may be at risk of aspiration. Further work is indicated to fully explore swallowing in this vulnerable group.