Dysphagia Flashcards
What are the causes of dysphagia?
Oesophageal cancer, oesophagitis, oesophageal candidiasis, achalasia, pharyngeal pouch, systemic sclerosis, mysathenia gravis, globus hystericus.
What presentation suggests that dysphagia is associated with oesophagitis?
May be history of heartburn.
Odynophagia but no weight loss and systemically well.
What presentation suggests that dysphagia is associated with oesophageal cancer?
Dysphagia may be associated with weight loss, anorexia or vomiting during eating.
PMHx may include: Barrett’s oesophagus, GORD, excessive smoking or alcohol use.
What presentation suggests that dysphagia is associated with oesophageal candidiasis?
May be history of HIV or other risk factors e.g. steroid inhaler use.
What presentation suggests that dysphagia is associated with achalasia?
Dysphagia of both liquids and solids from the start. Heartburn. Regurgitation of food with could lead to cough, aspiration pneumonia etc.
What is a pharyngeal pouch?
Represents a posteromedial herniation between the thyropharyngeus and cricopharyngeus muscles.
Usually not seen but if large then could be a midline lump in neck that gurgles on palpation.
More common in older men.
What are the typical symptoms of a pharyngeal pouch?
Dysphagia, regurgitation, aspiration and chronic cough. Halitosis may be seen.
What presentation suggests that dysphagia is associated with systemic sclerosis?
Other features of CREST syndrome may be present e.g. calcinosis, raynaud’s syndrome, oesophageal dysmotility, sclerodactyly, telangiectasia.
LOS pressure is decreased.
What presentation suggests that dysphagia is associated with myasthenia gravis?
Other symptoms may include extra-ocular muscle weakness or ptosis. Dysphagia with both liquids and solids.
What presentation suggests that dysphagia is associated with globus hystericus?
May be history of anxiety. Symptoms are often intermittent and relieved by swallowing. Usually painless.
