DYSPHAGIA Flashcards
Oropharyngeal causes of dysphagia?
Tumours of tongue or tonsil
Peritonsillar abscess
Zenkers diverticulum
Neurological - stroke, parkinsons, MS, MND, Myasthenia gravis
Globus hystericus
Oesophageal causes of dysphagia?
Oesophageal cancer
Oesophagitis
Oesophageal candidiasis
Peptic structures or oesophageal web or Schatzki ring
Foreign bodies lodged in oesophagus
Achalasia
External compression from a mediastinal mass, aortic aneurysm, lymphoma
Systemic sclerosis
Hypertensive peristalsis
Characteristics of dysphagia secondary to oesophageal cancer?
Progressive with food first
Weight loss
Anorexia
Vomiting after eating
History of barrets, GORD, smoking, alcohol
Characteristics of dysphagia secondary to oesophagitis?
Odynophagia
Systemically well
Hx of heart burn
Characteristics of dysphagia secondary to oesophageal candidiasis?
History of immunosuppression or steroid inhaler use
Characteristics of dysphagia secondary to Achalasia?
Dysphagia or solids and liquids from the start
Heart burn
Non-acidic regurgitation of food -> may lead to cough or aspiration pneumonia
Characteristics of dysphagia secondary to zenkers diverticulum?
Olde man with dysphagia, regurgitation, aspiration, chronic cough, halitosis, midline lump that gurgles on palpation
Characteristics of dysphagia secondary to systemic sclerosis?
Calcinosis
Raynaud’s phenomenon
Oesophageal dysmotility
Slcerodactyly
Telangiectasia
Characteristics of dysphagia secondary to myasthenia gravis?
easy fatigability and weakness of skeletal muscles in the ocular distribution = ptosis and diplopia.
Involvement of the facial and pharyngeal muscles affects speech and swallowing
proximal limb muscles can cause generalised weakness
Presentation of globus hystericus?
tightness or a pressure in your throat.
mucus that you cannot clear (catarrh)
an area of discomfort in your throat.
a feeling of something stuck or a lump in your throat.
May have a Hx of anxiety
Symptoms are intermittent and always painless
What can cause an oesophageal web?
GORD
Plummer-Vinson syndrome
What is Plummer-Vinson syndrome?
Dysphagia
IDA
Glossitis
What is a schatzki ring?
symptoms?
A benign ring of tissue in the distal oesophagus secondary to acid reflux irritation
Causes dysphagia, heart burn, regurgitation of food, odynophagia, severe chest pain known as ‘steakhouse syndrome’
Investigtaions for dysphagia?
FBC, LFTs, TFTs
Upper GI endoscopy
Fluoroscopic swallow
manometry studies can be done for potential motility disordr
