Dysphagia

Question 1

What is the definition of dysphagia

Answer 1

Difficulty in swallowing

Question 2

What are the phases of swallowing

Answer 2

Oral phase
Pharyngeal phase
Oesophageal phase

Question 3

Which structures are involved in the oral phase of swallowing

Answer 3

Tongue
Teeth
Saliva

Question 4

What happens during the pharyngeal phase

Answer 4

the larynx closes
Breathing stops
Tongue pushes food into the pharynx

Question 5

What happens during the oesophageal phase

Answer 5

Starts with opening of UOS (highest pressure) and LOS

Question 6

What are the different classifications of dysphagia

Answer 6

Anatomical:
- Oropharyngeal: Initiating swallowing
- Oesophageal: Propel material down oesophagus

Pathophysiological
- Structural
- Motility disorders

Question 7

Explain the epidemiology of dysphagia

Answer 7

1.6-15% in Middle age
13-35% of Elderly
20-60% Comorbidity such as diabetes, CVA, Head injuries

Question 8

Explain the history for the following pathophysiologies leading to dysphagia
- Structural
- Motility

And list other important factors to consider in the history

Answer 8

Structural:
- Solids at first progressing to liquids
- Acute food impaction

Motility:
- Both solids and liquids
- Neurological symptoms

Duration: Long with weight loss
Location of dysphagia: OPD
Associated symptoms: Heart burn
Medication: Centrally acting drugs

Question 9

What does the diagnostic workup consist of for dysphagia

Answer 9

Depends on suspected cause:
- Radiologist: Barium oesophagus, Corkscrew oesophagus
- Endoscopist
- Neurophysiologist