Current use of gastric acid-suppressive drugs has recently been discussed as associated with an increased risk of community-acquired pneumonia. We have also noted the relationship between acid exposure and the development of pneumonia in the elderly. Heretofore, we showed that a depressed swallowing reflex is an important responsible factor for the development of pneumonia in the elderly. Many older people have symptoms of dyspepsia or gastroesophageal reflux disease and so on, and oropharyngeal secretion or gastric content is often aspirated into the lower respiratory tract and subsequently causes pneumonia in the elderly with cerebrovascular disease. However, no one has shown the effect of acidity on the swallowing reflex in humans. Sixty participants, who were in stable condition such as without respiratory symptoms or pyrexia and gave informed consent, were recruited from 80 institutionalized patients in a nursing home in Japan. The nursing home serves as a long-term care facility for older patients who are physically handicapped or suffering from mental deterioration. The latency of swallowing reflex (LTSR) by a bolus injection of 1 mL of solution into the pharynx through a nasal catheter to induce the swallowing reflex was assessed. The LTSR was evaluated using latency of response, timed from injection to the onset of swallowing.
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