Dysphagia

Question 1

What is odynophagia?

Answer 1

Pain on swallowing

Question 2

Ix for oropharyngeal dysphagia?

Answer 2

-Video swallow
>provides function information
>can identify pharyngeal pouch

Question 3

Ix for Oesophageal dyshagia?

Answer 3

• Gastroscopy
• Barium Swallow
• CT scan
• Oesophageal manometry
• Endoscopic U/S

Question 4

Advantages of gastroscopy for investigation of dysphagia?

Answer 4

• Identify structural abnormality

- May be therapeutic (e.g. dilate stricture / remove foreign body)

Question 5

When is barium swallow useful in dysphagia work up?

Answer 5

• Achalasia

- If pharyngeal pouch suspected

Question 6

When is CT scan useful in dysphagia work up?

Answer 6

• -Assessment large hiatus hernia

- Extrinsic compression of oesophagus

Question 7

When is manometry useful in dysphagia work up?

Answer 7

-Assessment of achalasia or DES

Question 8

When is endoscopic u/s useful in dysphagia work up?

Answer 8

-Characterise lesions in the wall e.g. Gastrointestinal Stromal tumours (GIST)

Question 9

What is the cause of a pharyngeal pouch?

Answer 9

-Dysfunction / spasm of upper oesophageal sphincter

Question 10

Hx features suggestive of pharyngeal pouch?

Answer 10

• Gurgling in neck

- Brings up previously eaten foods

Question 11

Treatment of pharyngeal pouch?

Answer 11

Cricopharyngeal myotomy via

i) open procedure in the neck
ii) endoscopic transoral myotomy