diease

Dysphagia


Dysphagia overview and Definition

The dysphagia results in difficulty in swallowing. Difficulty swallowing means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain.


Clinical signs & symptoms

Choking when eating.

Coughing or gagging when swallowing.

Drooling.

Food or stomach acid backing up into the throat.

Hoarseness.

Recurrent heart burn

Sensation of food getting stuck in the throat or chest, or behind the breastbone.

Unexplained weight loss.

Bringing food back up (regurgitation).

Difficulty controlling food in the mouth.

Difficulty starting the swallowing process.

Recurrent pneumonia.

Inability to control saliva in the mouth.

The person might feel like the food has got struck.


Differential Diagnosis

Formal reflux analysis: This analysis involves a pH impedance test. Your doctor passes a thin tube through your nose, down your esophagus, and into your stomach to measure acid and non-acid reflux for 24 hours. For some people, doctors place a wireless pH probe in the esophagus to measure stomach acid levels. This probe, called Bravo, measures acid every six seconds for up to 96 hours. 

Barium esophagram: Your doctor may order this imaging study, which uses a special dye (barium) to help pinpoint areas of narrowing (stricture), examine muscle coordination, and determine whether the esophagus is retaining food. 

Esophageal manometry: This test assesses how well the esophageal sphincters open and close, and how well the esophagus moves food toward the stomach. sure on the catheter which is sensed, measured and recorded from each location. The magnitude of the pressure at each pressure-sensing location and the timing of the increases in pressure at each location in relation to other locations give an accurate picture of how the muscles of the pharynx and esophagus are contracting.

 

EndoFlip: This novel test measures the diameter and sensitivity of your esophagus. Your doctor also views any subtle obstructions that may be present. This innovative diagnostic procedure provides a wealth of information to create your treatment plan.

Endoscopy: Endoscopy involves the insertion of a long (one meter), flexible tube with a light and camera on its end through the mouth, pharynx, esophagus, and into the stomach. The biopsies can be obtained and the investigations are made. It is also useful for zenker’s divertivulitis.

X rays: The barium swallow or esophagram is the simplest type. During the evaluation the patient is asked to swallow  the barium and the  X rays. The barium swallow is excellent for diagnosing moderate to severe external compression, tumours and strictures of the esophagus.

Esophageal impedance:

It uses catheter similar to those used for esophageal manometry. Impedence testing senses the flow of the bolus through the esophagus. Hence this test is useful in evaluating how the food crosses the esophagus and also the esophagus pressures are viewed.

Esophageal acid testing:

It is a method used for determining whether or not there is reflux of acid from the stomach into the esophagus, a cause of the most common esophageal problem leading to dysphagia, esophageal stricture.


Prognosis

Dysphagic attacks are temporary and most patients recover fully from dysphagia when prompt treatment is given.


Prevention

Cut the food into pieces and then swallow.

Try different food texture and see which food is easy to swallow

Avoid alcohol and other beverages.