Dysphagia Flashcards
(27 cards)
Likely diagnosis if there was difficulty swallowing solids and liquids from the start
Motility disorder
Likely diagnosis if there is difficulty initiating the swallowing movement
Bulbar palsy
patient may cough on swallowing
What is the term used to describe painful swallowing?
Odynophagia
What is a possible cause of painful swallow?
ulceration
What is a possible cause of dysphagia without a painful swallow?
Spasm
What is a possible cause of intermittent dysphagia?
Oesophageal spasm
What is a possible cause of dysphagia that is constant and getting worse?
Malignant stricture
What is the likely diagnosis if the neck bulges or gurgles upon drinking?
Pharyngeal pouch
What is the relevance of Virchows node?
GI malignancy
What test could be done to confirm a pharyngeal pouch?
Contrast swallow
What test can be performed for dysmotility?
Oesophageal manometry
What can cause oesophagitis?
Complication of GORD
corrosives, NSAIDS, herpes, candida, duodenal ulcer, gastric ulcer, cancer
What would the PC of diffuse oesophageal spasm be?
Intermittent dysphagia +/- chest pain
What is achalasia?
Degeneration of the myenteric plexus leads to loss of coordinated peristalsis and a failure of the LOS to relax
What are the symptoms of achalasia?
Dysphagia, regurgitation, weight loss
Investigations for achalasia and what may they show
Manometry
Contrast swallow - shows dilated tapering oesophagus (birds beak)
What is the treatment for achalasia?
Endoscopic balloon dilation
Hellers cardiomyotomy (then PPI)
Botox
CCB and nitrates to relax sphincter
What are the benefits and problems with botox treatment for achalasia?
Non invasive
Has to be repeated every few months
Name some causes of a benign oesophageal stricture
GORD
Surgery
Corrosives
Radiotherapy
How can benign oesophageal stricture be treated?
Endoscopic balloon dilatation
Name some risk factors for oesophageal cancer
Diet, alcohol excess, smoking, achalasia, reflux oesophagitis, barretts oesophagus, obesity, hot drinks, nitrosamine exposure, plummer-vinson, male
What are the three features of Plummer-Vinson?
Post-cricoid dysphagia
Upper oesophageal web
Iron deficiency anaemia
Where are most oesophageal cancers?
50% middle
20% upper, 30% lower
What types of cancer can be found in the oesophagus and where?
Proximal -> Squamous cell
Distal -> Adenocarcinoma
