Dysphagia
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Introduction
The neurological exam looks for the control of swallowing, but doesn't look at function
prevent aspiration and pneumonia!
video fluoroscopy
Dysphagia is the sensation that food is sticking or other difficulties swallowing.
The Case of...
Differential Diagnosis
Oropharyngeal dysphagia is a problem with initiation of swallowing caused by neurologic or muscular diseases such as:
- Parkinson's disease
- stroke
- multiple sclerosis
- myasthenia gravis
- ALS.
- People with these conditions may notice pooling of food in the cheeks or an ability to move food to the back of the mouth. Coughing or sputtering suggests aspiration. Nasal regurgitation occurs if the soft palate fails to close.
Esophageal dysphagia can be due to mechanical obstruction, such as can occur with rings, strictures, or cancer, or problems with motility, as can occur with diffuse esophageal spasm, scleroderma, or achalasia.
Strictures can be
Esophageal cancer
CREST syndrome
History and Physical Exam
- history
- physical exam
History
Solids or liquids?
Both: motility
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Barium swallows or endoscopy can help identify the source of problems.
Bird's beak: achalasia
straight tube: scleroderma
Management
Pathophysiology
Resources and References
Topic Development
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