Dysphagia

From Orlhns

Dysphagia is a symptom which refers to a difficulty in swallowing. It should be differentiated from Odynophagia which refers to pain during swallowing. It is an important symptom and should not be neglected as dysphagia could be the only indication of an underlying serious malignancy / neurological disorder.

Contents 1 Approach to patient with dysphagia 1.1 History 1.2 Examination 1.2.1 Indirect laryngoscopy 2 Special investigations 2.1 Esophagoscopy 2.2 Barium swallow 2.3 Video Fluoroscopic evaluation of Swallow 2.4 Functional Endoscopic Evaluation of Swallowing 2.5 pH studies 2.6 Manometric studies 3 Causes

[edit] Approach to patient with dysphagia

[edit] History

[edit] Examination

[edit] Indirect laryngoscopy

Indirect laryngoscopy provides most useful information and can diagnose majority of cases with extra-esophageal dysphagia.

[edit] Special investigations

[edit] Esophagoscopy

An investigation to see the esophagus from within. This can be done using flexible and rigid esophagoscopes. In present times, a flexible esophagoscopy would suffice in most cases. A Rigid esophagoscopy is usually required to remove impacted foreign bodies.

[edit] Barium swallow

A radiological dynamic study where the observer evaluates the dynamics and morphology of the bolus using fluroscopy as the bolus passes down the upper aerodigestive tract and esophagus.

[edit] Video Fluoroscopic evaluation of Swallow

[edit] Functional Endoscopic Evaluation of Swallowing

[edit] pH studies

[edit] Manometric studies

[edit] Causes

• Achalasia cardia
• Foreign Body
• Reflux esophagitis
• Benign strictures
• Malignancy
• Dysphagia lusoria
• Neurological