Dysphagia Flashcards
What is dysphagia?
difficulty in swallowing
endoscopy is essential
painful swallowing = odynophagia
What are malignant causes of dysphagia ?
- Oesophageal cancer
- Pharyngeal cancer
- gastric cancer
- extrinsic pressure i.e. lung cancer / node enlargement
What are neuro causes of dysphagia?
- Bulbar palsy
- lateral medullary syndrome
- mysasthenia gravis
- syringomyelia
What are other causes of of dysphagia ?
- Benign strictures
- pharyngeal pouch
- achalasia
- systemic sclerosis
- oesophagitis
- iron deficiecy anaemi
What to ask in hx of patient with dysphagia?
- dyspepsia ?
- weight loss?
- lumps?
- progressive dysphagia?
What tests for dysphagia ?
Bloods:
* FBC, ESR
Imaging:
* CXR
* Barium swallow
* endoscopy + biopsy
* oesphageal motiliy studies
Pt with dysphagia:
Ask: can fluid be drunk as fast as normal except if food is stuck.
What are you differentials if patients says yes or no
If pt says yes
* suspect a stricture (benign / malignant)
Pt says no:
* think of motility disorder (achalasia, neuro cause)
Pt with dysphagia ask: is it difficult to make the swallowing movement ?
if pt says yes, what is differencial?
Yes:
* suspect bulbar palsy (especically if cough on wwallowing )
Pt with dysphagia ask: is it difficult to make the swallowing movement?
if pt says yes, what is differencial?
Yes:
* suspect bulbar palsy (especically if cough on wwallowing )
Pt with dysphagia ask: Is the dysphagia constant and painful?
Yes: what is differencial
Yes:
* think malignant stricture
Pt with dysphagia ask: Does the neck bulge or gurgle on drinking?
if patient says yes what is your differential?
Yes:
* suspect a pharyngeal pouch
* also food may be regurgitated
