2011 Volume 15 Issue 2 Pages 214-219
[Purpose] There is a high frequency of swallowing difficulty complaints among patients with Sjögren's syndrome which impairs their quality of life. This study aimed to evaluate the efficacy of pilocarpine hydrochloride for the symptom by analyzing the change of saliva flow rate, subjective evaluation of dry mouth and videofluorography findings.
[Methods] Three female patients (aged 67, 45 and 35 years) diagnosed as primary Sjögren's syndrome were enrolled in this study. Cases A and B took 15 mg pilocarpine daily and case C took 5 mg. Before and after pilocarpine treatment, the stimulated saliva flow values during chewing of gum, the subjective evaluation of dry mouth on a 100-mm visual analog scale (VAS) and the oropharyngeal transit time obtained from videofluoroscopic images using 1.5 g of barium cookie as a test food were examined.
[Results] After one month of treatment, the saliva flow value of case A increased by 0.7 ml/10 min, that of case B decreased by 0.5 ml/10 min and that of case C increased by 18.0 ml/10 min. The subjective evaluation of dry mouth on VAS of case A was improved from 91 mm to 26 mm, case B from 52 mm to 0 mm and case C from 79 mm to 18 mm. Case A could not swallow the 1.5 g cookie before the treatment, but could swallow it in 56 seconds after the treatment. The oropharyngeal transit time of case B shortened from 46 seconds to 38 seconds and that of case C from 23 seconds to 13 seconds.
[Conclusion] After the pilocarpine treatment, the subjective evaluation of dry mouth and the oropharyngeal transit time of these three cases were improved, while the stimulated saliva flow values during chewing of gum changed variously. It is suggested that the mouth was moistened by an increased unstimulated saliva flow and a food bolus was formed smoothly.
