(12) Swallowing Disorders Flashcards
What is Dysphagia?
Difficulty in swallowing
Difficulty in the passage of solids or liquids from the mouth to the stomach.
What is Odynophagia?
Pain on swallowing, with or without dysphagia
What conditions may cause oropharyngeal dysphagia?
Neuromuscular
Mechanical
What conditions may cause esophageal dysphagia?
Dysmotility
Mechanical
Define Dysmotility
Problem with relaxation and contraction of
sphincters and peristalsis
What is used to diagnose swallowing disorders?
Barium swallow x-ray
Upper GI Endoscopy
Modified Barium Swallow Study [MBSS]
Fiberoptic Endoscopic Evaluation of Swallowing [FEES]
What is the significance of FEES in diagnosis?
One of the most sensitive and specific tools for identifying aspiration and penetration
What are the neuromuscular causes of Oropharyngeal dysphagia?
Bulbar/ pseudobulbar palsy
Motor Neuron Disease
Myasthenia gravis
What are the symptoms of Oropharyngeal dysphagia?
Difficulty in initiating swallowing.
Choking, aspiration, coughing.
Nasal regurgitation.
Drooling, dysarthria, hoarseness and cranial nerve or other neurological signs may be present.
What is the mechanical cause of Oropharyngeal dysphagia?
Oropharyngeal tumors and its treatment
What are the malignant causes of mechanical esophageal dysphagia?
Esophageal cancer
Gastric cancer [proximal stomach i.e. cardia]
Extrinsic compression [Lung cancer/mediastinal tumors]
What are the benign causes of mechanical esophageal dysphagia?
Peptic strictures Corrosive strictures Esophageal webs/rings Benign neoplasia Enlarged left atrium Eosinophilic esophagitis
What are the symptoms of mechanical esophageal dysphagia?
Patients complain of food ‘sticking’ after swallowing.
Patient usually point to the suprasternal notch as the site of obstruction.
The site of discomfort correlates poorly with the actual site of disease.
Dysphagia may be progressive.
There may be episodes of food/bolus impaction.
There may be associated weight loss, especially in malignant obstruction.
What is the treatment of benign mechanical obstruction?
Endoscopic therapy [curative]
Medical therapy [not used alone]
Surgery [last resort]
What is eosinophilic esophagitis?
Esophageal dysfunction and eosinophilic infiltration of the esophageal mucosa. It is can be associated with atopy
