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Dysphagia

Dysphagia. Dr. Meg- angela Christi Amores. Dysphagia. a sensation of "sticking" or obstruction of the passage of food through the mouth, pharynx, or esophagus often used as an umbrella term to include other symptoms related to swallowing difficulty. Definition of terms. Aphagia

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Dysphagia

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  1. Dysphagia Dr. Meg-angela Christi Amores

  2. Dysphagia • a sensation of "sticking" or obstruction of the passage of food through the mouth, pharynx, or esophagus • often used as an umbrella term to include other symptoms related to swallowing difficulty

  3. Definition of terms • Aphagia • signifies complete esophageal obstruction • Odynophagia • painful swallowing • Globuspharyngeus • is the sensation of a lump lodged in the throat • Phagophobia • meaning fear of swallowing

  4. Physiology of Swallowing

  5. Pathophysiology of Dysphagia • oral, pharyngeal, and esophageal • mechanical dysphagia - caused by a large bolus or a narrow lumen is called • motor dysphagia - due to weakness of peristaltic contractions or to impaired deglutitive inhibition causing nonperistaltic contractions and impaired sphincter relaxation

  6. Oral phase dysphagia • associated with poor bolus formation and control • food may either drool out of the mouth or overstay in the mouth • patient may experience difficulty in initiating the swallowing reflex • premature spillage of food into the pharynx and aspiration into the unguarded larynx and/or nasal cavity

  7. Pharyngeal phase Dysphagia • associated with stasis of food in the pharynx due to poor pharyngeal propulsion and obstruction at the UES • leads to nasal regurgitation and laryngeal aspiration during or after a swallow • Nasal regurgitation and laryngeal aspiration during the process of swallowing are hallmarks

  8. EsophagealDysphagia • the esophageal lumen can distend up to 4 cm • When the esophagus cannot dilate beyond 2.5 cm in diameter, dysphagia to normal solid food can occur • when the esophagus can’t distend beyond 1.3 cm, dysphagiaALWAYS occurs

  9. History • can provide a presumptive diagnosis in >80% of patients • Nasal regurgitation and tracheobronchial aspiration with swallowing are hallmarks of pharyngeal paralysis or a tracheoesophageal fistula • Hoarseness • precedes dysphagia, the primary lesion is usually in the larynx • following dysphagia may suggest involvement of the recurrent laryngeal nerve

  10. History • Type of food • Difficulty only with solids implies mechanical dysphagia with a lumen that is not severely narrowed • dysphagia occurs with liquids as well as solids in advanced obstruction • Duration • Transient dysphagia may be due to an inflammatory process • Progressive, lasting days to weeks - carcinoma

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