dysphagia

Question 1

what are the two phases of swallowing where issue can occour?

Answer 1

• oro-pharangeal phase (struggle to get food to leave the mouth)
• oesophageal phage (get stuck after leaving the mouth)

Question 2

what is odynophagia?

Answer 2

painful swallowing

Question 3

what can cause oesophageal dysphagia?

Answer 3

• physical obstruction
  e. g tumour, stricture, inflammation from oesophagitis
• Neuromuscular problems e.g achalasia (Lower oesophageal sphincter doesn’t open with swallowing), dysmotility (abnormal muscular function) and presbyoesophagus (abnormal shape oesophagus)

Question 4

how can you diagnose the cause of oesophageal dysphagia?

Answer 4

OGD needed to exclude obstructive cause, then a barrium swallow or oesophageal manometry can be done to look for neuromuscular problems.

then can treat depending on cause, e.g dilation for benign strictures and surgery or stenting for cancers.

Question 5

what causes oropharyngeal dysphagia?

Answer 5

usually due to co-ordination issues with muscles that move the food bolus to the back of the mouth, as a result of neurological disease e.g a stroke

a cranial nerve examination should be done, and obtain speech therapy assessment

video fluoroscopy may be helpful

if it remains unsafe with altered food consistencies an enteral feeding tube may be necessary.