Dysphagia Flashcards
What are extrinsic causes of dysphagia?
mediastinal masses
cervical spondylosis
systemic sclerosis
What are oesophageal wall causes of dysphagia?
achalasia
diffuse oesophageal spasm
hypertensive LOS
What are intrinsic causes of dysphagia?
tumours
strictures
oesophageal strictures
What are neuro causes of dysphagia?
CVA Parkinsons MS Myasthenia gravis Lateral medullary syndrome Bulbar palsy
if fluid can be drunk as fast as usual, what would u suspect?
if it can’t, what would u suspect?
YES - stricture (benign or malignant)
NO - motility disorder (achalasia, neuro cause)
If it is difficult to make the swallowing movement? what would u suspect?
bulbar palsy (esp if they cough on swallowing)
If the dysphagia is constant and painful what would u suspect?
malignant stricture
If the neck bulges or gurgles on drinking what would u suspect?
pharyngeal pouch
What tests would u do for dysphagia?
Upper GI endoscopy
Oesophageal motility studies
Barium swallow
FBC, ESR
What is oesophageal carcinoma associated w?
achalasia
alcohol
smoking
barretts
What causes benign oesophageal strictures?
reflux
swallowing corrosives
foreign body
trauma
what is. rx of benign oesophageal strictures?
dilatation
What is rx of pharyngeal pouch?
endoscopic stapling.
What clinical features would make u think of oesophageal cancer?
weight loss
anorexia
vomiting during eating
what are the clinical features of oesophagitis?
hx of heartburn
odynophagia but NO WL + systemically well
What features in a hx may suggest oesophageal candidiasis?
hx of HIV
Steroid inhaler use
What features in a hx may suggest achalasia?
dysphagia of both liquids and solids from the start
heartburn
regurgitation of food
what are the risks of achalasia?
regurgitation may lead to aspiration pneumonia
What features alongside dysphagia may suggest myasthenia graves?
extra ocular muscle weakness or ptosis
dysphagia is w liquids as well as solids
What is globus pharyngeus?
sensation of a lump in the throat when not swallowing food w no primary swallowing difficulty
What is globus hystericus?
sensation of lump in the throat
associated w anxiety
sx intermittent and relieved by swallowing
usually painless
