Disorders Of Oesophagus

Question 1

Normal swallow

Answer 1

1. Pre-oral ingestion = hunger, visual, expectations, motor skills
2. Voluntary = bolus moved into pharynx
3. Involuntary = upper sphincter relaxation, peristalsis, lower sphincter relaxation

Question 2

Disorders

Answer 2

Tears/perforation
Foreign bodies
Fear of choking
Barretts oesophagus
Reflux oesophagitis

Question 3

Dysphagia

Answer 3

Difficulty swallowing

IDDSI food texture document

Question 4

Dysphagia:

Primary diagnosis

Answer 4

Stroke
Parkinsons
Head injury

Question 5

Dysphagia:

S+S

Answer 5

Weak voice
Coughing
Gurgly voice
Drooling
Delayed swallow
Sudden weight loss

Question 6

Dysphagia:

Diagnosis

Answer 6

Water swallow test

Videofluoroscopy

Question 7

Dysphagia:

Complications

Answer 7

Malnutrition
Dehydration
Fear of choking
Aspiration

Question 8

Dysphagia:

Management

Answer 8

Assess swallow
Determine safe route + appropriate texture
Ensure nutrient needs met
Monitor

Question 9

Stricture

Answer 9

Abnormal narrowing

Benign or malignant

Question 10

Stricture:

Treatment

Answer 10

Dilation

- may need to be repeated

Question 11

Stricture:

Complications

Answer 11

Decreased appetite

Weight loss

Question 12

Achalasia

Answer 12

Weak oesophageal peristalsis
Lower sphincter fails to relax
Food remains in oesophagus - pain, regurgitation

Question 13

Cancer:

Risk factors

Answer 13

Smoking

Alcohol

Question 14

Cancer:

Treatment

Answer 14

Surgery
Chemotherapy
Radiotherapy

Question 15

Cancer:

Oesophagectomy

Answer 15

Total or partial
Tumour portion removed
Anastomosis formed
Stomach pulled up into thoracic cavity

Question 16

Cancer:

Stent

Answer 16

Palliative treatment
Possible blockage - bread...
Fluids 24hr post insertion
May req gradual intro of soft foods
Individual advice based on ability, tumour extent etc

Advice - sit upright, chew well, don’t rush, plenty fluids