Effects of a Sour Bolus on Oropharyngeal Swallowing Measures in Patients With Neurogenic Dysphagia

TLDR

The study investigates how a sour bolus of lemon juice and barium affects pharyngeal swallow measures in patients with neurogenic dysphagia. The study included 19 stroke patients and 8 patients with other neurogenic dysphagia, all selected for delayed oral and pharyngeal swallow onset on 1 ml and 3 ml liquid barium boluses during videofluoroscopy. Sour boluses significantly improved oral onset, reduced pharyngeal delay in stroke patients, lowered aspiration frequency in non‑stroke patients, and enhanced other swallow measures, though volume effects were less consistent than previously reported.

Abstract

This study examines the effects of a sour bolus (50% lemon juice, 50% barium liquid) on pharyngeal swallow measures in two groups of patients with neurogenic dysphagia. Group 1 consisted of 19 patients who had suffered at least one stroke. Group 2 consisted of 8 patients with dysphagia related to other neurogenic etiologies. All patients were selected because they exhibited delays in the onset of the oral swallow and delays in triggering the pharyngeal swallow on boluses of 1 ml and 3 ml liquid barium during videofluoroscopy. Results showed significant improvement in oral onset of the swallow in both groups of patients and a significant reduction in pharyngeal swallow delay in Group 1 patients and in frequency of aspiration in Group 2 patients with the sour as compared to the non-sour boluses. Other selected swallow measures in both subject groups also improved with the sour bolus. Volume effects were present but not as consistently as in prior studies. Implications for swallow therapy are discussed.