Dysphagia

Question 1

What is dysphagia?

Answer 1

Difficulty swallowing

Question 2

1) Name a mechanical cause of dysphagia
2) Name a ‘motility disorder’ cause of dysphagia
3) Name a neurological cause of dysphagia
4) Name another cause of dysphagia

Answer 2

1) Malignancy (pharyngeal, oesophageal, gastric), benigns strictures, extrinsic pressure (lung cancer, mediastinal lymph nodes, retrosternal goitre), pharyngeal pouch
2) Achalasia, oesophageal spasm, systemic sclerosis
3) Cerebrovascular disease, Parkinson’s disease, MND, bulbar palsy
4) Oesophagitis (reflux, candida, HSV), globus

Question 3

1) If liquids and solids are being equally affected from the start - what broad cause of dysphagia is implied?
2) If solids were affected at the start then liquids - what does this imply about the cause of dysphagia?
3) If it is difficult to initiate a swallowing movement - what is the suspected cause?
4) Name 2 conditions painful dysphagia (odynophagia) implies
5) What does a bulging neck on swallowing, gurgling or halitosis imply?

Answer 3

1) Motility
2) Benign/malignant stricture
3) Bulbar palsy/neurological cause
4) Candida infection, malignancy, ulcer or spasm
5) Pharyngeal pouch

Question 4

1) Dysphagia and what else suggests Plummer-Vinson syndrome?
2) Plummer Vinson syndrome is associated with what condition?

Answer 4

1) Iron deficiency anaemia
2) Squamous cell carcinoma of the oesophagus.

Question 5

How is pharyngeal pouch managed?

Answer 5

Surgery

Question 6

How is oesophageal spasm managed?

Answer 6

CCBs