Dysphagia Flashcards
define dysphagia
subjective awareness of impairment in the passage of food from the oropharynx to the stomach
odynophagia
burning or pain while swallowing
causes of oropharyngeal dysphagia
neuromuscular disease, local mechanical lesions or upper oesophageal sphincter disorders
neuromuscular disorders causing oropharyngeal dysphagia
- cerebrovascular disease
- Parkinson’s disease
- multiple sclerosis
- motor neurone disease
- myasthenia gravis
- myopathy
local mechanical lesions causing oropharyngeal dysphagia
- malignancy
- pharyngeal infections
- vertebral osteophytes
- prior head and neck radiation
- proximal oesophageal webs
- zenkers diverticulum
- thyroid goitre
- cardiac disease
upper osophageal sphincter disorders causing oropharyngeal dysphagia
cricopharyngeal spasm, which causes sensations of choking, tightness and sensation of lump
causes of oesophageal dysphagia
peptic stricture
oesophageal malignancy
eosinophilic oesophagitis
oesophageal web/ring
extrinsic compression
sub epithelial lesion
peptic stricture
associated with reflux, peptic ulcer disease, hiatus hernia, heavy alcohol use.
oesophageal malignancy
adenocarcinoma - associated with smoking and Barrett’s oesophagus
or squamous cell cancer - associated smoking, excess alcohol, human papilloma virus
eosinophilic oesophagitis
symptoms related to oesophageal dysfunction
eosinophil dominant inflammation on oesophageal biopsy
associated with atopy and allergies
oesophageal web/ring
thin mucosal structures that can be asymptomatic
extrinsic compression
eg.
mediastinal structures
cardiac and vascular structure
enlarged thyroid
cervical osteophytes
sub epithelial lesions
arising within the wall of the oesophagus from second, third or forth layers
usually cancer eg. leiomyoma, GI stomal tumour, granular cell tumour
investigations for oropharyngeal symptoms
speech pathology assessment
oesophageal investigations
upper GI endoscopy
contrast swallow
high resolution manometry
cross sectional imaging
