Dysphagia Flashcards
Define it
Intraluminal causes:
- Infection - 4
- Common in children
- Also found in colon which is precancerous
Difficulty swallowing
Candiadiasis
Pharyngitis
Retropharyngeal abscess
Oesophagitis
Foreign body
Polyps
Intramural (in muscular layer) causes:
- What can GORD cause?
- Starts with A
- Can be caused by iron deficiency anaemia
- Similar to above
- you can get these in any muscle of the body
Benign strictures - can also get malignant strictures
Achalasia
Oesophageal web
Oesophageal ring
Oesophageal spasm
Extramural causes:
- Something pharyngeal
- A type of hernia
- Possibly involved in every compressive process
Pharyngeal pouch
Rolling hiatus hernia
Malignancy
Neurological causes:
List a few
Stroke Myasthenia gravis MS MND Parkinson's
Mneumonic for history - MUNCH LOT
Movement Underweight Neck bulges Cough on lying Heartburn
Liquids
Odynophagia - painful swallowing
Time pattern
MUNCH LOT
What does difficulty making swallowing movement mean?
What does being underweight indicate?
What does a bulging neck when drinking indicate?
Bulbar/pseudobulbar palsy - have you had difficulty initiating swallowing
Malignancy - have you unintentional weight recently
Pharyngeal pouch - do you find your neck bulging or some gurgling when drinking?
MUNCH LOT
What does a cough on lying down mean? - 2
Has it been a problem with liquids and solids from start?
- Yes???
- No? - solids then liquids
Achalasia
Pharyngeal pouch
(The food is coming back up causing them to cough)
The food is going back up causing them to cough
Motility problem - systemic sclerosis, mysasthenia gravis
Pharyngeal problem
Stricture - benign or malignant
MUNCH LOT
What does heart burn indicate?
Do you have pain swallowing? - Yes
GORD
Cancer
Ulcer
Oesophageal spasm - relieved GTN
MUNCH LOT
Time:
What does it mean if it is:
- intermittent
- constant/worsening
- both
Spasm
Malignant stricture
Achalasia
Signs on examination:
What does cachexia indicate?
What does Virchows node suggest?
What other examinations can you do for systemic disease?
Malnutrition
Intra-abdominal malignancy
Neuro exam - CNS disease
Investigations:
Why do FBC and U&E?
Imaging for general upper GI pathology?
Test for pharyngeal pouch?
How to test for dysmotility?
Anaemia
Dehydration
Upper GI endoscopy +/- biopsy
Barium/contrast swallow - pouch
Oesophageal manometry
Oesophageal spasm
2 symptoms
2 ways to investigate?
Intermittent dysphagia
Chest pain
Contrast swallow
Manometry
Achalasia
What is it?
Big differentiating symptom
LES fails to open during swallowing
Regurgitation of food
What causes a benign oesophageal stricture?
1 way to treat?
GORD
Surgery
Corrosives
Radiotherapy
Endoscopic balloon dilatation
