Photo Credit: Kazuma Seki

Mild-to-moderate IPF may cause adaptive changes in feeding that are closely linked to nutritional status, lung function, and the severity of dyspnea.

Swallowing is an intricate process that necessitates the coordinated activity of muscles in the mouth, pharynx, larynx, and esophagus, explained a study published online in BMC Pulmonary Medicine. Dysphagia, a condition marked by difficulty swallowing, can significantly exacerbate respiratory diseases by potentially increasing lung disease exacerbations and hastening the decline in pulmonary function. This study sought to examine swallowing dynamics in patients with idiopathic pulmonary fibrosis (IPF) and its association with tongue pressure, pulmonary function, and overall health status.

Patients with IPF were assessed using several tools: the Eating Assessment Tool (EAT-10) for swallowing difficulties, tongue pressure measurements, the Timed Water Swallow Test (TWST), and the Test of Mastication and Swallowing Solids (TOMASS). These findings were then correlated with dyspnea severity as evaluated by the modified Medical Research Council (mMRC) score, nutritional status via the Mini Nutritional Assessment (MNA), and pulmonary function tests, including spirometry, diffusing capacity for carbon monoxide (DLCO), maximal inspiratory pressure (PImax), and maximal expiratory pressure (PEmax). The study comprised 34 individuals with IPF.

Results indicated that those with modifications in swallowing had significantly lower MNA scores than those without swallowing issues (9.6 ± 0.76 vs. 11.64 ± 0.41 points; mean difference 1.98 ± 0.81 points; P=0.02), indicating poorer nutritional status. Additionally, these patients exhibited reduced lung function, precisely in predicted forced vital capacity (FVC; 81.5% ± 4.61% vs. 61.87% ± 8.48%; mean difference 19.63% ± 9.02%; P=0.03). A significant alteration in the speed of liquid swallowing was observed in 91.1% (31 of 34) of the subjects.

The number of liquid swallows significantly correlated with the forced expiratory volume in 1 second (FEV1)/FVC ratio (r=0.3; P=0.02). Solid eating and swallowing, as assessed by the TOMASS score, also correlated with lung function, where the number of chewing cycles correlated negatively with PImax% predicted (r=-0.4; P=0.0008) and PEmax% predicted (r=-0.3; P=0.02). FVC% predicted was negatively correlated with increased solid swallowing time (r=-0.3; P=0.02), and the severity of dyspnea further impacted solid swallowing.

Overall, patients with mild-to-moderate IPF may exhibit adaptive changes in feeding that are closely linked to their nutritional status, lung function, and the severity of dyspnea, underscoring the need for comprehensive management strategies in this population.