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A problem swallowing
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
The word dysphagia is derived from the Greek words ‘dys’ (with difficulty) and ‘phagia’ (to eat). Dysphagia is a subjective sensation that patients experience, and indicates an abnormality as liquids and/or solids pass from the mouth to the stomach. Patients’ complaints range from the inability to initiate a swallow, to the sensation of liquids and/or solids ‘sticking’ as they pass through the oesophagus into the stomach. The term ‘odynophagia’ refers to pain with swallowing.
Symptomatic Giant Hiatal Hernia with Intrathoracic Stomach
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Large hiatal herniae often cause a degree of obstruction. Patients describe dysphagia and/or odynophagia. As a result, patients modify their diet to avoid solids like bread or meat, and chew their food more thoroughly. They eat smaller meals and eat them more slowly. This is associated with early satiety, but rarely weight loss. Because these dietary changes are often subtle and long term, patients require direct questioning to elucidate these symptoms.
Upper Gastrointestinal Surgery
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Odynophagia➢ Painful swallowing➢ Causes of Odynophagia: Trauma: Radiation, oesophageal burn, oesophageal ruptureForeign Body: Oropharyngeal or oesophagealGORD: Oesophagitis, oesophageal ulcerationInfective: Pharyngitis, tonsillitis, oesophagitis (HSV/Candida), abscessNeoplasia: Pharyngeal/Laryngeal/Oesophageal carcinomaMotility-related: Achalasia, oesophageal dysmotlity disordersOther: Scleroderma
Breakthrough cancer pain in the radiotherapy setting: a systematic and critical review
Published in Expert Review of Anticancer Therapy, 2023
In a retrospective analysis, 42 patients with oropharyngeal cancer at clinical stages I–IVA were treated with adjuvant RT or RT-CT or definite RT or RT-CT, oropharyngeal cancer. Changes of the analgesic regimen occurred throughout the 6–7 week period of RT administration, with a more frequent administration of strong opioids. BP was recorded in 10 (23.8%) patients, after about four weeks of RT or RT-CT. BT was treated with non-opioid drugs or oral morphine. However, data about efficacy was not reported. Oral morphine syrup was the more frequently prescribed among patients with odynophagia. This choice was probably dictated by the presence of an inflamed mucosa for swallowing tablets., Pain intensity decreased by continued to be a significant clinical issue. The analgesic treatment was maintained in about 3/4 of patients after RT or RT-CT completion [10].
Forget-me-not: Lemierre’s syndrome, a case report
Published in Journal of American College Health, 2023
Benjamin Silverberg, Melinda J Sharon, Devan Makati, Mariah Mott, William D Rose
Symptoms are somewhat nonspecific and include fever, rigors, odynophagia, difficulty swallowing, trismus, neck pain, and/or oropharyngeal swelling. (Of these, rigors and unilateral neck swelling represent red flags that may necessitate admission to the intensive care unit [ICU] and antibiotic coverage for anaerobes.) The tonsils do not necessarily appear exudative or ulcerated.17 Unilateral neck swelling and tenderness from thrombophlebitis of the IJV is often mistaken for cervical lymphadenopathy.16,17 The so-called "cord sign" is actually induration of the IJV under the anterior border of the SCM muscle.14,31 Evidence of thrombophlebitis can also be found with advanced imaging; a CT scan of the neck with contrast is the gold standard, but MRI or even ultrasound may be utilized.4,10,11,16,17,26,27,33 Workup does usually start with a plain chest X-ray, but this can be normal in a minority of cases.32 Myalgias, arthralgias, productive cough, hemoptysis, dyspnea, pleuritic chest pain, and abdominal pain are also possible.23,32
Swallowing and communication outcomes following primary transoral robotic surgery for advanced or recurrent oropharyngeal cancer: Case series
Published in International Journal of Speech-Language Pathology, 2022
Emma Charters, Hans Bogaardt, Amy Freeman-Sanderson, Kirrie Ballard, Sarah Davies, Justine Oates, Jonathan Clark
In the interpretation of outcomes, it is important to note that all patients had changed their diet slightly prior to surgery. This was primarily due to xerostomia in the recurrent cases, and odynophagia in the advanced cases. In each case, this affected their ability to consume solids, rather than liquids, and none were reliant on a feeding tube prior to their TORS procedure. The post-TORS impairments in swallowing identified on FEES are consistent with previous literature demonstrating that TORS procedures result in a swallowing pattern characterised by (a) reduced base of tongue propulsion, (b) incomplete pharyngeal contraction and shortening and c) reduced or absent white out, suggesting absent epiglottic retroflexion and restricted hyolaryngeal elevation and excursion (Charters et al., 2020). The severity, however, in the cases of larger deficits or salvage cases appeared to be more severe.