Objective
To investigate esophageal motility disorders in patients with esophageal residual barium on chest x-rays after videofluoroscopic swallowing studies (VFSS) through high-resolution esophageal manometry (HREM).
Methods
We reviewed the records of 432 patients who underwent VFSS from September 2019 to May 2021, and 85 patients (19.7%) with large residual barium (diameter ≥1 cm) were included. As a result of HREM, motility disorders were classified as major or minor motility disorders according. Esophagogastroduodenoscopy and chest computed tomography results available were also reviewed.
Results
Among 85 patients with large residual barium in the esophagus, 16 patients (18.8%) underwent HREM. Abnormal esophageal motilities were identified in 68.8% patient: three patients (18.8%) had major motility disorders—achalasia (n=1), esophagogastric junction (EGJ) outflow obstruction (n=2)—and eight patients (50%) had minor motility disorders—ineffective esophageal motility (n=7), fragmented peristalsis (n=1). In those with normal esophageal motility, three patients of esophageal structure disorders (18.8%)—esophageal cancer (n=1), cardiogenic dysphagia (n=1), slight narrowing without obstruction of EGJ (n=1)—and two patients (12.5%) with chronic atrophic gastritis (n=2) were confirmed.
Conclusion
Esophageal motility disorders were identified in 68.8% of 16 patients with large esophageal residual barium with three patients in the major and eight patients in the minor categories. Residual barium in the esophagus was not rare and can be a sign of significant esophageal motility disorders.

Objective: To evaluate the presence of swallowing difficulties in patients with post-poliomyelitis syndrome (PPS) by characterizing their swallowing patterns with videofluoroscopic swallowing study. Method: Eleven patients diagnosed with PPS were enrolled. All subjects answered the self assessment questionnaire for swallowing difficulty and gastric symptoms. We assessed the ability of tongue control, the oral transit time, cricopharyngeal opening time, and pharyngeal transit time. We also assessed the presence of aspiration or penetration and the amount of residue in the vallecular and pyriform sinus by four grade scales. A gastroenterologist examined esophagus, stomach and duodenum through an esophagogastroduodenoscopy. Results: Six patients complained swallowing difficulty and nine patients showed symptoms of esophageal regurgitation. Although finding of penetration or aspiration was not seen, all patients showed swallowing dysfunction in the videofluoroscopic swallowing study. In the esophagogastroduodenoscopy, chronic superficial gastritis was observed in all enrolled patients (n=11) and reflux esophagitis was found in 4 patients (36%). Conclusion: About half patients with PPS complained of dysphagia. Routine evaluation of dysphagia with videofluoroscopic swallowing study and esophagogastroduodenoscopy is needed in all patients with PPS due to the low reliability in their subjective symptom. (J Korean Acad Rehab Med 2008; 32: 411-416)