DYSPHAGIA
Case study
* A 51 yr.old female presented with a hx of dysphagia that has been progressively worsening for months. Initially dysphagia was for solids only but more recently it is for both solids and liquids.
* Which of the following studies will most likely establish the diagnosis
* EGD
* Barium swallow
* CT
* manometry
Case study
* A 52 year-old male executive c/o intermittent dysphagia which began 2 years ago. When he is eating, he has episodes of the sudden sensation of food sticking in his throat after he swallows, lower chest discomfortand hypersalivation. On two occassions the discomfort has caused him to regurgitate undigested food. There is now wt loss.Physical exam is normal
* The most likely diagnosis is
* Achalasia
* Diffuse esophageal spasm
* Esophageal ring
* Peptic stricture
* Adenocarcinoma
INTRODUCTION
* Dysphagia—difficulty with swallowing—is a common condition, reported by 5–8% of the general population aged over 50 years, and by 16% of the elderly.
* Dysphagia, particularly oropharyngeal dysphagia, is even more common in the chronic-care setting; up to 60% of nursing-home occupants have feeding difficulties that include dysphagia.
Esophageal Anatomy
SWALLOWING
REVIEW
Swallowing Stages
* Oral
* Pharyngeal
* Esophageal
HISTORY
Where is the site of bolus hold-up?
OROPHARYNGEAL VS ESOPHAGEAL
Etiology of oropharyngeal dysphagia.
ESOPHAGEAL
* Differntiation mechanical vs motility disorder?
Is the dysphagia for solids or liquids
Motility- features
How long has dysphagia been present? Is it intermittent? Is it progressive?
Examination of the patient with dysphagia
Investigation of esophageal dysphagia
NO DYSPHAGIA
INTERMITTENT DYSPHAGIA FOR SOLIDS
DYSPHAGIA WITH LONG HX OF GERD
Bulge in the left side of the neck while eating
DYSPHAGIA FOR SOLIDS AND LIQUIDS WITH WT LOSS
DYSPHAGIA FOR SOLIDS AND LIQUIDS
INTERMITTENT DYSPHAGIA FOR SOLIDS AND LIQUIDS
IRON DEFIIENCY ANEMIA
DYSPHAGIA.ppt
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