Presentation
We present the case of a 62-yr-old patient who developed severe swallowing problems 5 yr after radiotherapy for a pharyngeal carcinoma. [ncbi.nlm.nih.gov]
The most common presentations in the head and neck are ptosis, diplopia, dysarthria, and dysphagia. Stroke Central nervous system injury induced by hemorrhagic or ischemic stroke, both hemispheric and brainstem insults, can lead to dysphagia. [armandoh.org]
During MBS, barium representing different food consistencies is presented and motion imaging is recorded as these different consistencies are swallowed. [ukhealthcare.uky.edu]
Common presentations of pediatric dysphagia symptoms are listed in table 2. [karger.com]
Some people present with "silent aspiration" and do not cough or show outward signs of aspiration. Undiagnosed dysphagia can also result in dehydration, malnutrition, and kidney failure. [en.wikipedia.org]
Gastrointestinal
-
Failure to Thrive
An 8-week-old infant was referred because of suspicion of cricopharyngeal achalasia causing persistent swallowing problems and failure to thrive. [ncbi.nlm.nih.gov]
Workup
Successful management requires multidisciplinary collaboration, accurate diagnostic workup and effective therapeutic strategies. [clinmedjournals.org]
Based on the results of these tests and evaluations, you can either resume the patient’s per os (PO) diet or perform further workup as indicated. Malignancy Certain historical symptoms are more suggestive of dysphagia due to malignancy. [cancertherapyadvisor.com]
(See Prognosis, Clinical Presentation, Workup, and Treatment.) [emedicine.medscape.com]
Successful management requires interdisciplinary collaboration, accurate diagnostic workup, effective therapeutic strategies, and consideration for unique patient characteristics. [oralcancerfoundation.org]
Treatment
Endoscopy Endoscopic procedures are a mainstay of dysphagia treatment. [stanfordhealthcare.org]
Because there are many reasons why dysphagia can occur, treatment depends on the underlying cause. Thorough examination is important, and implementation of a treatment strategy should be based on evaluation by a multidisciplinary team. [clinmedjournals.org]
Dysphagia Treatment Some swallowing problems may be treatable with therapy, medication or surgery. Depending on your working diagnosis, your treatment team will discuss different treatment options available. [hopkinsmedicine.org]
Swallowing therapy can be initiated years after cancer treatment, since the effects of chemoradiation can occur long after treatment is completed. [oralcancerfoundation.org]
Early intervention results in the best treatment outcomes, so seeking treatment at the first sign of an impairment is very important. [swallowingdisorderfoundation.com]
Prognosis
[…] to remove anything lodged in the throat Exercises to strengthen and improve the muscles of the throat and esophagus Medication to control heartburn, esophagitis, or GERD Surgery to remove blockages The cause of your dysphagia will also determine the prognosis [dhaendoscopy.com]
As a general rule, the earlier a serious problem is diagnosed, the better the chance that treatment may improve the outlook (prognosis). [patient.info]
The prognosis for people with neurologic dysphagia depends upon the type of swallowing problem they are experiencing, and the course of the neurological disorder that produces it. [entcolumbia.org]
What Is the Prognosis for Dysphagia? It is not possible to predict the prognosis or outlook for dysphagia in general because so many different conditions can be responsible for this symptom. [emedicinehealth.com]
(See Prognosis, Clinical Presentation, Workup, and Treatment.) [emedicine.medscape.com]
Etiology
Surgery may be necessary depending on the etiology of the dysphagia. Contact a GI doctor for a consultation if you have trouble swallowing. Please contact our Gastroenterology Specialists for diagnosis and treatment of dysphagia. [midlandsclinic.com]
It provides excellent visualization of anatomical changes and identifies the etiology of residue, penetration and aspiration. Videofluoroscopy and FEES is thought to be the "gold standard" for assessment of in oropharyngeal dysphagia [8]. [clinmedjournals.org]
As always, history is very important in identifying the etiology of dysphagia. The first step is to distinguish oropharyngeal from esophageal dysphagia. [cancertherapyadvisor.com]
[…] any objective weakness Recurrent aspiration pneumonia Dysphagia that occurs in conjunction with an acute neurologic event is likely the result of that event; new dysphagia in a patient with a stable, long-standing neurologic disorder may have another etiology [merckmanuals.com]
Movement of the hyoid bone and the epiglottis during swallowing in patients with dysphagia from different etiologies. J Electromyogr Kinesiol. 2008 Apr. 18(2):329-35. [Medline]. Veis SL, Logemann JA. [emedicine.medscape.com]
Epidemiology
Dysphagia: epidemiology, risk factors and impact on quality of life -- a population-based study. Ailment Pharmacol Ther. 2008;27(10):971-9. Ferri FF. Ferri's Clinical Advisor 2016. 1st ed. Philadelphia, PA: Elsevier Mosby; 2016. Gonsalves N. [mountsinai.org]
Levels 0 – 4, while foods are measured from Levels 3 – 7.[23] It is likely that this initiative, which has widespread support among dysphagia practitioners, will improve communication with carers and will lead to greater standardisation of modified diets Epidemiology [en.wikipedia.org]
(See Epidemiology and DDx.) [emedicine.medscape.com]
Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston, Mass: Little, Brown, and Company; 1991.Google Scholar 19 Review manager 4.2. Available at: . Accessed June 14, 2004.Google Scholar 20 Teasell R, McRae M, Marchuk Y, Finestone HM. [ahajournals.org]
Pathophysiology
Philipsen BB (2019) Dysphagia - Pathophysiology of Swallowing Dysfunction, Symptoms, Diagnosis and Treatment. J Otolaryngol Rhinol 5:063. doi.org/10.23937/2572-4193.1510063 [clinmedjournals.org]
To better serve this vulnerable group of patients, healthcare providers must inquire about the presence of dysphagia and have a working knowledge of its pathophysiology. [gastroenterologyandhepatology.net]
(See Pathophysiology and Etiology.) Dysphagia should be differentiated from disorders that prevent transfer of food to the mouth or beyond the stomach but that are not characterized by difficulty swallowing. [emedicine.medscape.com]
Jadcherla SR, Hogan WJ, Shaker R: Physiology and pathophysiology of glottic reflexes and pulmonary aspiration: from neonates to adults. Semin Respir Crit Care Med 2010;31:554-560. Tutor JD, Gosa MM: Dysphagia and aspiration in children. [karger.com]
[…] is a better technique to visualize biomechanical information not seen with screening methods, thus increasing its likelihood of capturing movement patterns that reflect the effects of aging on the swallowing mechanism but not necessarily swallowing pathophysiology [ahajournals.org]
Prevention
Is Dysphagia Preventable? Dysphagia is preventable only to the extent that the underlying condition that caused the dysphagia is preventable. Many chronic neuromuscular conditions and diseases of connective tissue are not preventable. [emedicinehealth.com]
There are not steps to prevent esophageal dysphagia. [winchesterhospital.org]
This prevents dehydration and malnutrition. [healthline.com]
When the muscles involved in swallowing are working properly, they close off and protect the airway to prevent food or liquid from entering the lungs. [swallowingdisorderfoundation.com]
Sometimes this can prevent food from reaching the stomach. Scleroderma. In this condition, tissues of the esophagus become hard and narrow. [umcvc.org]