Dysphagia: Difficult Swallowing

Dysphagia means difficulty in swallowing, the word "dysphagia" is derived from the Greek dys meaning bad or disordered, and the root phag- meaning "eat".

Associated Signs and symptoms

  • Difficulty in swallowing
  • Sensation of food getting stuck in your throat or chest
  • Regurgitation
  • Heartburn
  • Coughing especially when Supine
  • Weight loss
  • Aspiration pneumonia

Causes

Swallowing disorders can occur in all age groups, but the incidence is higher in the elderly. According to site involved it can be of two type-

  1. Oropharyngeal Dysphagia
  2. Esophageal Dysphagia

1.          Oropharyngeal Dysphagia

Patient is unable to transfer food bolus from mouth into the upper esophagus.

Two types

Structural (obstructive)-

Neurological (propulsive)-

Structural (obstructive)-

  • Tumors of tongue and Tonsils
  • Peritonsillar abscess
  • Zenker Diverticulum

Neurological (propulsive)-

  • Stroke
  • Parkinson disease
  • Motor neuron disease
  • Multiple sclerosis
  • Myasthenia gravis

Diagnosis – modified barium swallow studies

Treatment

  • Treat underlying pathology
  • Swallowing exercises
  • Dietary changes (soft and easy to swallow foods)

2.          Esophageal Dysphagia

Two types

Structural (obstructive)-

Neurological (propulsive)-

Structural (obstructive)

Internal obstruction within the esophagus

  • Esophageal carcinoma
  • Esophageal strictures (GERD or radiation exposure)- dilation is treatment
  • Foreign body obstruction

External compression

  • Mediastinal masses

Neurological (propulsive)

  • Achalasia
  • Scleroderma
  • Nutcracker esophagus

Diagnosis

  • Upper GI endoscopy and biopsy
  • Barium swallow study
  • Esophageal motility study

Treatment

  • Treat the underlying cause
  • Dilation of stricture
  • Removal of external compression

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Dysphagia Infographics
Dysphagia Infographics

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Revision for today https://creativemeddoses.com/topics-list/fetal-alcohol-syndrome-fas/

Good explanatory video https://www.youtube.com/watch?v=jK1o3LSQmB0

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