The oesophagus
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
Dysphagia is used to describe difficulty with swallowing. When there is a problem with swallowing in the voluntary (oral or pharyngeal) phases, patients will usually say that they cannot swallow properly, but they do not characteristically describe ‘food sticking'. Instead, when they try to initiate a conscious swallow, food fails to enter the oesophagus, stays in the mouth or enters the airway, causing coughing or spluttering. Virtually all causes of this type of dysphagia are chronic neurological or muscular diseases. Oesophageal dysphagia occurs in the involuntary phase and is characterised by a sensation of food sticking. The nature of this type of dysphagia is often informative with regard to a likely diagnosis. Dysphagia may occur acutely or in a chronic fashion, can affect solids and/or fluids, and be intermittent or progressive.
Procedures
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Diagnostic:1 To ascertain the cause of dysphagia.2 To ascertain the cause of upper GI bleed (oesophageal varices, peptic ulcer, etc).3 Reflux oesophagitis.4 Acid peptic disease (APD).5 Gastric outlet obstruction.6 Upper GI malignancy.
Swallowing disorders
Declan Costello, Guri Sandhu in Practical Laryngology, 2015
The viewpoint of the patient regarding their symptom of dysphagia is critical to understanding its impact and strategies for management. It is also surprising how many patients do not admit to particular difficulties unless questioned directly. As a method of understanding further a patient’s degree of dysphagia impairment and of gauging the effect of treatment over time, patient-reported tools may be helpful. The Eating Assessment Tool-10 (EAT-10) is a validated 10-item questionnaire encompassing aspects of deglutition such as what food types can be managed as well as the social effect of swallow problems (see Appendix 8.1).11 It may be completed in 5 minutes by rating each item from 0 (no problem) to 4 (severe problem) and then calculating the sum total. Validation studies demonstrate that scores >3 indicate a swallowing problem. Alternative assessment tools include the MD Anderson Dysphagia Inventory (MDADI; specific for head and neck cancer patients) (see Appendix 8.2), the Sydney Swallowing Questionnaire (SSQ) (see Appendix 8.3), and the Swallowing Quality of Life (SWAL-QOL) (see Appendix 8.4). The MDADI is a 20-item survey with three domains and a single global question. It is designed to assess swallow in the patient with head and neck cancer.12 The SSQ contains 17 items and patients score on a visual analogue scale, and the SWAL-QOL contains 10 domains with multiple questions and is correlated with symptom frequency.13–16 Although not diagnostic, rating scales do help define the extent of symptoms and impact on the patient’s life.
A survey of public awareness of dysphagia
Published in International Journal of Speech-Language Pathology, 2021
Lindsay D. McHutchion, Julia M. Pringle, My-Han N. Tran, Amberley V. Ostevik, Gabriela Constantinescu
Dysphagia describes difficulty or discomfort swallowing. Those affected by dysphagia are demographically and aetiologically diverse. For example, dysphagia may be related to neurological, degenerative and rheumatoid diseases, or cancer and the side-effects of its treatment. It can also arise as a result of progressive conditions, including aging related changes (Sura, Madhavan, Carnaby, & Crary, 2012). Estimates of the prevalence of dysphagia demonstrate wide variability and range from 25% to 45% in typically developing children, 33% to 80% in children with developmental disorders, between 16% and 22% among individuals older than 50 and between 14% and 40% in adults over 60 (Koidou, Kollinas, Sdravou, & Grouios, 2013). A 2014 study of self-reported health of United States residents estimates that one in 25 adults in the United States experiences dysphagia annually (Bhattacharyya, 2014).
Characterizing dysphagia after spinal surgery
Published in The Journal of Spinal Cord Medicine, 2021
Anna Miles, Gabi Jamieson, Lara Shasha, Kelly Davis
Dysphagia after SCI and spinal surgery is not surprising in view of the proximity of the injury, surgery, and permanent plating to vital cranial nerves and muscles involved in swallowing. The cause of dysphagia is likely multifactorial: neuronal, muscular and mucosal1 as well as more generic contributors such as level of consciousness, pharmacological effects, intubation/ventilation effects, cognition, positioning and psychological effects (anxiety and mood). To date, little attention has been given to the physiological impairments leading to swallowing difficulties after SCI. Without an understanding of physiology, individualized rehabilitation programmes for those with persisting dysphagia are not possible. This study explored severity, longevity, and physiological characteristics of dysphagia after spinal surgery. The authors answered the following questions: How many patients receive input from a speech-language pathologist (SLP) for dysphagia assessment after SCI? What are the demographic characteristics of those referred compared with those who are not referred? How long do swallowing difficulties last? What are the common symptoms of dysphagia? What are the common physiological impairments?
Cross-cultural adaptation and validation of the Swallowing Disturbance Questionnaire and the Sialorrhea Clinical Scale in Portuguese patients with Parkinson’s disease
Published in Logopedics Phoniatrics Vocology, 2021
Ana Rita Cardoso, Isabel Guimarães, Helena Santos, Joana Carvalho, Daisy Abreu, Nilza Gonçalves, Joaquim J. Ferreira
Oro-buccal symptoms, such as dysphagia and sialorrhea, are common in Parkinson´s disease (PD) patients (PwP), with an estimated prevalence of 82% for dysphagia when assessed with objective measures [1] and between 23 and 84% for sialorrhea, according to the most recent studies [2–10]. Dysphagia symptoms include coughing, choking, chewing limitation, difficult management of food and liquids in the mouth, drooling, nasal regurgitation, food lodging in the pharynx and aspiration, which contribute to a serious risk of dehydration, malnutrition and pneumonia secondary to aspiration [11]. Sialorrhea in particular influences health status by causing discomfort, frequent choking and aspiration pneumonia in severe cases [12]. Both oro-buccal symptoms have a considerable impact in PwP and their caregivers’ quality of life [7]
Related Knowledge Centers
- Mouth
- Odynophagia
- Oropharyngeal Dysphagia
- Pharynx
- Stomach
- Swallowing
- Signs & Symptoms
- Globus Pharyngis
- Psychogenic Disease
- Phagophobia