About Me

header ads

Cardinal Symptoms in the Gastroenterology: Dysphagia (swallowing problems, Difficulty Swallowing) | Definition, Symptoms and causes


    Definition

    It means distressed swallow act as a result of many conditions, there are – according to the site of the disturbance two types of dysphagia:

    Dysphagia_swallowing_problems_Difficulty_Swallowing
    Source: sacent.com


    Oropharyngeal

    mostly coordination problem of the upper esophageal sphincter

    Causes:

    Cerebral:
    • Ischemia
    • Bulbar/ pseudobulbar paralysis
    • Polyneuropathy
    • Parkinson
    • Multiple sclerosis

    Tumors: of the tongue and pharynx
    Muscular:
    • Myasthenia gravis
    • Muscle dystrophy

    Iatrogenic: after operations of the neck
    Zenker's diverticulum

    Esophageal

    mostly mechanical Stenosis:

    Mechanical
    • 65%
    • Esophageal carcinoma: the most common cause of older patients
    • Mediastinal tumors: lymphomas
    • Spinal osteophytes
    • Webs (Plummer Vinson syndrome)
    • Peptic stenosis

    Neuromuscular
    • 15%  (+ reflux esophagitis) the most common cause by younger patients
    • Achalasia
    • Hypercontractile Oesophagus
    • Kollagenosen: dermatomyosclerosis

    Epithelial lesions
    • 15%
    • Ulcerations (reflux esophagitis, Barret-Ulcus, Crohn, medicament induced)
    • CMV
    • Candidiasis
    • Eosinophil esophagitis

    Pseudo dysphagia (without organic lesions)

    Diagnosis

    1. Clinical anamneses:
    • Is the swallow distress by hard or soft food or both? Carcinoma, motoric
    • Will it increase by continuing eating? Diverticula
    • Is it of weeks, years? Tumors, achalasia
    • Are there other symptoms: wright Los? Pain? Etc …
    • Endoscopic diagnostic: tumors? Webs? Ulcerations? Esophagitis?

    2. Gastroscopy + biopsies
    3. Motoric diagnosis: Esophageal manometry: achalasia, hypercontractile esophagus
    4. Esophageal PH-metry: Reflux?
    5. Barium swallow: achalasia? Diverticula?

    Source: Duale Reihe: innere Medicine: 3 Auflage 

    Post a Comment

    0 Comments