St George Swallow Centre

Department of Gastroenterology and Hepatology, and Speech Pathology, St George Hospital and University of NSW, Sydney, Australia

Research in Progress

    • Long term (15yrs) outcomes following pneumatic dilatation for oesophageal achalasia. 
    • Safety and outcomes following pneumatic dilatation for post-surgical recurrence of symptoms in achalasia.
    • Biomechanics of the pharyngeal swallow following laryngectomy and evaluation of safety and efficacy of cricopharyngeal dilatation. 
    • Predicting dysphagia-related complications and improving outcomes in head and neck radiotherapy patients. 
    • Development and validation of novel fibreoptic strain sensors for evaluation of longitudinal shortening of the human oesophagus during swallowing.
    • Modulation of oesophageal afferent pathways by 5-HT3 receptor inhibition.
    • Utilization of novel high resolution manometry and impedance in the assessment of  pharyngeal dysphagia complicating stroke and predicting  treatment needs and outcomes.

    Original publications in last 5 years (swallowing research only)

    • Elliott TR, Wu PI, Fuentealba S, Szczesniak M, de Carle DJ, Cook IJ. Long-term outcome following pneumatic dilatation as initial therapy for idiopathic achalasia: an 18-year single-centre experience. Aliment Pharmacol Ther. 2013 Jun;37(12):1210-9. 
    • Kumbhari V, Behary J, Szczesniak M, Zhang T, Cook IJ. Efficacy and safety of pneumatic dilatation for achalasia in the treatment of post-myotomy symptom relapse. Am J Gastroenterol. 2013 Jul;108(7):1076-81. doi: 10.1038/ajg.2013.32. Epub 2013 Mar 5.
    • Szczesniak MM, Fuentealba SE, Zhang T, Cook IJ., Modulation of esophageal afferent pathways by 5-HT3 receptor inhibition. Neurogastroenterol Motil. 2013 May;25(5):383-8, e293.
    • Szczesniak MM, Fuentealba SE, and Cook IJ. Acid Sensitization of Esophageal Mucosal Afferents: Implication for Symptom Perception in Patients across the Gastroesophageal Reflux Disease Spectrum. Clin J Pain. 2013 Jan;29(1):70-7 
    • Szczesniak MM, Williams RB, Cook IJ. Mechanisms of Esophago-Pharyngeal Acid Regurgitation in Human Subjects. PLoS ONE 2011; 6(7):e22630 - (Download PDF) 
    • Szczesniak MM, Williams RBH, Brake HM, Maclean JC, Cole IE, Cook IJ. Upregulation of the oesophago-UES relaxation response: a possible pathophysiological mechanism in suspected reflux laryngitis. Neurogastroenterol Mot 2010;22(4):381- 386, e89.
    • MacLean J, Szczesniak MM, Cotton S, Cook IJ, Perry A. Impact of a laryngectomy and surgical closure technique on swallow biomechanics and dysphagia severity. Otolaryngol Head Neck Surgery 2010;144:21-28.
    • Chen CL, Szczesniak MM, Cook IJ.  Evidence for esophageal visceral hypersensitivity and aberrant symptom referral in patients with globus. Neurogastroenterol Motil 2009;21:1142-e96.
    • Szczesniak MM, Rommel N, Dinning PG, Fuentealba SE, Cook IJ, Omari T.  Intraluminal impedance detects failure of pharyngeal clearance during swallowing: A validation study in adults with dysphagia.  Neurogastroenterol Mot. 2009: 21(3):244-52. (Download PDF)
    • Szczesniak MM, Rommel N, Dinning P, Fuentealba S, Cook I, Omari T. Optimal criteria for detecting bolus passage across the pharyngo-oesophageal segment during the normal swallow using intraluminal impedance recording. Neurogastroenterol Mot. 2008: May;20(5):440-447. 
    • Szczesniak MM, Fuentealba SE, Burnett A, Cook IJ. Differential relaxation and contractile responses of the human upper esophageal sphincter mediated by interplay of mucosal and deep mechanoreceptor activation. Am J Physiol Gastrointest Liver Physiol. 2008 Apr;294(4):G982-G988.(Download PDF)
    • Chen CL, Yi CH, Cook IJ. Differences in oesophageal bolus transit between patients with and without erosive reflux disease. Dig Liver Dis. 2008 May;40(5):348-354.
    • Chen CL, Szczesniak MM, Cook IJ.  Identification of impaired oesophageal bolus transit and clearance by secondary peristalsis in patients with non-obstructive dysphagia. Neurogastroenterol Motil. 2008;20(9):980-988.
    • Chen CL, Szczesniak MM, Cook IJ.  Oesophageal bolus transit and clearance by secondary peristalsis in normal individuals.  European Journal of Gastroenterology & Hepatology 2008;20(12):1129-1135.
    • Lee G, Craig PI, Freiman JS, de Carle DJ, Cook IJ. Intermittent dysphagia for solids associated with a multiringed esophagus: clinical features and response to dilatation. Dysphagia 2007; 22(1): 55-62.

    Selected review articles and book chapters

    • Cook IJ. Zenker's Diverticulum.In: Shaker R, Postma G, Belafsky P, Easterling C, Eds. Principles of Deglutition: A Multidisciplinary Text for Swallowing and its Disorders. New York: Springer: 2012: In press.
    • Cook IJ. Cricopharyngeal bar and Zenker’s diverticulum. Gastroenterology and Hepatology 2011;7(8):540-543.
    • Cook IJ. Combined pharyngeal impedance-manometry. Has it finally come of age? Clin Gastroenterol Hepatol 2011;9(10):813-815 (Link)
    • Cook IJ. Oropharyngeal dysphagia. In Talley NJ, Tangalos EG eds. Gastroenterol Clin Nth Am; Gastroenterology in the Elderly: Saunders, 2009:38:411-31
    • Cook IJ. Diagnostic evaluation of dysphagia. Nature Clin Pract Gastroenterol Hepatol 2008;5:393-403.
    • Cook IJ. Clinical disorders of the upper esophageal sphincter. In: Goyal and Shaker’s GI  Motility Online; Edited by Goyal, RK and Shaker, R Nature Publishing Group; New York, 2006 (Link)
    • Galmiche JP, Clouse RE, Baunt A, Cook IJ, Kahrilas PJ, Paterson WG, Smout AJPM. Functional esophageal disorders. Gastroenterology 2006: 130:1459-65
    • Cook IJ. Disorders causing oropharyngeal dysphagia. In: Castell DO, Richter J eds. The Esophagus. 4th ed. Philadelphia: Lippincott Williams and Wilkins, 2004;196-220.
    • Cook IJ, Kahrilas PJ. American Gastroenterological Association clinical practice guidelines: management of oropharyngeal dysphagia. Gastroenterology 1999;116(2):455-478

    Selected notable publications (pre 2007, field of swallowing only)

    • Williams RB, Szczesniak M, Maclean J, Brake HM, Cole IE, Cook IJ. Predictors of outcome in an open label, therapeutic trial of high dose omeprazole in laryngitis. Am J Gastroenterol 2004; 99(5):777-85. (Download PDF)
    • Williams RB, Grehan MJ, Hersch M, Andre J, Cook IJ. Biomechanics, diagnosis, and treatment outcome of inflammatory myopathy presenting as oropharyngeal dysphagia. Gut 2003;52(4):471-478. (Download PDF)
    • Pal A, Williams RB, Cook IJ, Brasseur JG. Intrabolus pressure gradient identifies pathological constriction in the upper esophageal sphincter during flow. Am J Physiol 2003; 285:G1037-1048. (Download PDF)
    • Hui JM, Hunt DR, de Carle DJ, Williams RB, Cook IJ. Esophageal dilatation for post-fundoplication dysphagia: safety, efficacy and predictors of outcome. Am J Gastroenterol 2002; 97(12):2986-2991.
    • Williams RB, Wallace KL, Ali GN, Cook IJ.  Biomechanics of failed deglutitive upper esophageal sphincter relaxation in patients with neurogenic dysphagia. Am J Physiol 2002;283:G16-G26. (Download PDF)
    • Wallace KW, Middleton S, Cook IJ. Development and validation of a self-report symptom inventory to assess the severity of oral-pharyngeal dysphagia. Gastroenterology 2000;118:678-687. (PDF, More information)
    • Williams RB, Ali GN, Wallace KL, Wilson JS, deCarle DJ, Cook IJ  Esophagopharyngeal acid regurgitation: Dual pH monitoring criteria for its detection and insights into mechanisms. Gastroenterology 1999;117:1051-61.
    • Ali GN, Wallace KL, Zagami A, deCarle DJ, Cook IJ. Mechanisms of oral-pharyngeal dysphagia in Parkinson’s disease. Gastroenterology 1996; 110(2): 383-392.
    • Shaw DW, Cook IJ, Gabb M, Holloway RH, Simula ME, Panagopoulos V, Dent J. Influence of normal aging on oral-pharyngeal and  upper  esophageal  sphincter  function  during swallowing. Am J Physiol 1995; 268:G389-G396.
    • Cook IJ, Blumbergs P, Cash K, Jamieson GG, Shearman DJ.  Structural abnormalities of the cricopharyngeus muscle in patients with pharyngeal (Zenker's) diverticulum.  J Gastroenterol Hepatol 1992;7:556-562.
    • Cook IJ, Gabb M, Panagopoulos V, Jamieson GG, Dodds WJ, Dent J, Shearman DJ.  Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening. Gastroenterology 1992;103:1229-1235. (Download PDF)
    • Cook IJ, Dodds WJ, Dantas RO, Massey B, Kern MK, Lang JM, Brasseur JG, Hogan WJ.  Opening mechanisms of the human upper esophageal sphincter.  Am J Physiol  1989;257:G748-G759.

    Research presentations 

    • Maclean J, Szczesniak MM, Zhang T, Cook IJ. Dysphagia and dysphonia following total laryngectomy surgery. Presentation to Laryngectomee Association of NSW (2013) - (Download PDF PowerPoint)
    • Szczesniak MM, Maclean J, Zhang T, Graham P, Cook IJ. Prevalence of dysphagia as a long term complication of head and neck radiotherapy, Oral Presenation 3rd Congress of the European Society for Swallowing Disorders (2013)
    • Szczesniak1 MM, Omari TI, Maclean J, Liu R, Zhang T, Cook IJ Inter-rater reliability of automated impedance-manometry (AIM) analysis and fluoroscopy in patients with dysphagia following head and neck radiotherapy. Oral Presenation 3rd Congress of the European Society for Swallowing Disorders (2013)
    • Szczesniak MM, Cook IJ.  Normal values for Sydney Swallow Questionnaire (SSQ) Poster Presenation, 3rd Congress of the European Society for Swallowing Disorders (2013)
    • Szczesniak MM, Fuentealba SE, Cook IJ. Involvement of 5-HT3 neural pathways in oesophageal sensitivity and acid-induced viscerosomatic sensitisation, Journal of Gastroenterology and Hepatology 2012; 27 (Suppl. 4): 161182 (oral presentation AGW Adelaide(2012)
    • Paramsothy S, Maclean J, Szczesniak MM, Cook IJ. Cricopharyngeal Dilatation for Post Laryngectomy Dysphagia - a Pilot Study of Efficacy and Safety. Gastroenterology, Volume 142, Issue 5, Supplement 1, May 2012, Page S-235
    • Paramsothy S, Maclean J, Szczesniak MM, Cook IJ. 
    • Kumbhari V, Behary J, Szczesniak MM, Naidoo M, Cook IJ. Efficacy and Safety of Pneumatic Dilatation in Patients With Achalasia Who Relapse Post Heller Myotomy. Gastroenterology, Volume 142, Issue 5, Supplement 1, May 2012, Page S-282
    • Maclean J, Cook IJ. Dysphagia following total laryngectomy surgery. Presentation to Laryngectomee Association of NSW (2012) - (Download PDF PowerPoint)
    • Maclean J, Szczesniak M, Zhang T, Graham, P, Cook IJ. Dysphagia is a prevalent and under recognized complication of head and neck radiotherapy.  Dysphagia Research Society 20th Annual Meeting, Toronto, Canada (2012 Oral presentation) - (Download PDF PowerPoint)
    • Maclean J, Szczesniak M, Paramsothy S, Zhang T, Graham, P, Cook IJ. Esophageal dysmotility in laryngectomy patients; an unrecognised association?.  Dysphagia Research Society 20th Annual Meeting, Toronto, Canada (2012 Poster Presentation) - (Download PDF)
    • Szczesniak MM, Maclean J, Cotton S, Cook IJ, Perry A. Videomanometric evaluation of dysphagia following total laryngectomy. Australian Gastroenterology Week (2009 Oral Presentation) - (Download PDF )

    Other research articles (past 5 years only)

    • Dinning PG, Hunt L, Arkwright JW, Patton V, Szczesniak MM, Wiklendt L, Davidson JB, Lubowski DZ, Cook IJ.  Pancolonic motor response to sub-and suprasensory sacral nerve stimulation in patients with slow transit constipation. Br J Surgery 2012; In press. 
    • Arkwright JW, Blenman NG, Underhill ID, Maunder SA, Spencer NJ, Costa M, Brooks SJ,  Szczesniak MM, Dinning PG. A fibre optic catheter for simultaneous measurement of longitudinal and circumferential muscular activity in the gastrointestinal tract. J Biophotonics 2011;4(4): 244-257.
    • Dinning PG, Jones M, Hunt L, Fuentealba SE, Kalanter K, King DW, Lubowski DZ, Talley NJ, Cook IJ. Factor analysis identifies subgroups of constipation. World J Gastroenterol 2011;17(11):1468-1474.
    • Dinning PG, Hunt L, Lubowski DZ, Kalantar J, Cook IJ, Jones M. The impact of laxative use upon symptoms in patients with proven slow transit constipation. BMC Gastroenterol 2011;11: 12
    • Dinning PG, Szczesniak MM, Cook IJ.  Spatio-temporal analysis reveals aberrant linkage among sequential propagating pressure wave sequences in patients with symptomatically defined obstructed defecation. Neurogastroenterol Motil 2009;21(9):945-e75.
    • Arkwright JW, Underhill JW, Maunder SA, Blenman NG, Szczesniak MM, Wiklendt L, Cook IJ, Lubowski DZ, Dinning PG.  Design of a high-sensor count fiber optic manometry catheter for in vivo colonic diagnostics. Optics Express 2009;17(25):22423-22431.
    • Dinning PG, Szczesniak, M.M. Cook, IJ. Proximal colonic propagating pressure wave sequences and their relationship with movements of content in the proximal human colon. Neurogastroenterol Motil. 2008 May;20 (5):512-520. 
    • Dinning PG, Szczesniak MM, Cook IJ. Determinants of postprandial flow across the human ileocecal junction:  A combined manometric and scintigraphic study. Neurogastroenterol Motil. 2008 Oct;20(10):1119-26.
    • Dinning PG, Szczesniak MM, Cook IJ.  Twenty-four hour spatiotemporal pressure mapping of colonic pressure waves provides pathophysiological insight into constipation. Neurogastroenterol Motil. 2008 Sep;20(9):1017-21.
    • King S, Catto-Smith AG, Stanton MP, Sutcliffe J, Simpson D, Cook IJ, Dinning PG, Hutson JM, Southwell BR.  24-hour colonic manometry in children with slow transit  constipation demonstrates significant reduction in antegrade propagation. Am J Gastroenterol 2008;103:2083-2091.
    • Dinning PG, Fuentealba SE, Kennedy ML, Lubowski DZ, King D, Cook IJ. Sacral nerve stimulation induces pan-colonic propagating pressure waves and increases defaecation frequency in patients with slow transit constipation. Colorectal Dis 2007; 9(2): 123-132