dysphagia Flashcards
Globus hystericus (globus hystericus)
Symptoms are often intermittent and relieved by swallowing food or drink. Swallowing of saliva is often more difficult.
May be history of anxiety
Oesophageal cancer
Dysphagia may be associated with weight loss, anorexia or vomiting during eating
Past history may include Barrett’s oesophagus, GORD, excessive smoking or alcohol use
Oesophagitis
May be history of heartburn
Odynophagia but no weight loss and systemically well
Oesophageal candidiasis
There may be a history of HIV or other risk factors such as steroid inhaler use
Achalasia
Dysphagia of both liquids and solids from the start
Heartburn
Regurgitation of food - may lead to cough, aspiration pneumonia etc
Pharyngeal pouch
More common in older men
Represents a posteromedial herniation between thyropharyngeus and cricopharyngeus muscles
Usually not seen but if large then a midline lump in the neck that gurgles on palpation
Typical symptoms are dysphagia, regurgitation, aspiration and chronic cough. Halitosis may occasionally be seen
What is Halitosis
bad breath
what is Achalasia
lower eosophangeal sphincter (stomach door) fails to open while swallowing
Systemic sclerosis
Other features of CREST syndrome may be present, namely Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia
As well as oesophageal dysmotility the lower oesophageal sphincter (LES) pressure is decreased. This contrasts to achalasia where the LES pressure is increased
Myasthenia gravis
Other symptoms may include extraocular muscle weakness or ptosis
Dysphagia with liquids as well as solids
Extrinsic causes of dyspagia
Mediastinal masses
Cervical spondylosis
Oesophageal wall causes of dyspagia
Achalasia
Diffuse oesophageal spasm
Hypertensive lower oesophageal sphincter
Intrinsic causes of dyspagia
Tumours
Strictures
Oesophageal web
Schatzki rings
Neurological causes of dyspagia
CVA Parkinson's disease Multiple Sclerosis Brainstem pathology Myasthenia Gravis
