Quantitative assessment of dysphagia in patients with primary and secondary Sjögren's syndrome

Dysphagia is a common complaint from patients with salivary gland dysfunction. The purpose of this study was to assess and compare dysphagia in two patient groups with salivary gland dysfunction (primary Sjögren's syndrome and secondary Sjögren's syndrome with systemic lupus erythematosus, and a matched control group. Subjects diagnosed with primary Sjögren's syndrome (n=13) and secondary Sjögren's syndrome with systemic lupus erythematosus (n=15) were selected for the study. An age- and sex-matched group of control subjects (n=14) was selected for comparison. Dysphagia assessments, including videofluoroscopy were performed. Dysphagia was quantified clinically and videofluoroscopically by measurement of 10 seconds of basal or dry swallows as compared with 10-second 10-ml water bolus swallows in all subjects. Subjective evaluations were recorded on a calibrated 10-cm visual analog scale. The results indicated a significant difference in the dry swallows as compared with the water bolus swallows for both salivary gland dysfunction groups and for both dry swallows and water bolus swallows as compared to controls. Videofluoroscopy yielded significantly prolonged pharyngeal transit times in both salivary gland dysfunction groups as compared with control. Subjective results indicated a greater degree of dysphagia symptoms in both the salivary gland dysfunction groups (p<0.001). Conclusions from this study indicate clinically significant dysphagia in patients with salivary gland dysfunction associated with Sjögren's syndrome compared with a control population.