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Dysphagia



 
 
Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10
ICD-10

The International Statistical Classification of Diseases and Related Health Problems10th Revision is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization ....
, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia.

It derives from the Greek root dys meaning difficulty or disordered, and phagia meaning "to eat". It is a sensation that suggests difficulty in the passage of solids or liquids from the mouth
Mouth

The mouth, buccal cavity, or oral cavity is the first portion of the alimentary canal that receives food and begins digestion by mechanically breaking up the solid food particles into smaller pieces and mixing them with saliva....
 to the stomach
Stomach

In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
.






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Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10
ICD-10

The International Statistical Classification of Diseases and Related Health Problems10th Revision is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization ....
, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia.

It derives from the Greek root dys meaning difficulty or disordered, and phagia meaning "to eat". It is a sensation that suggests difficulty in the passage of solids or liquids from the mouth
Mouth

The mouth, buccal cavity, or oral cavity is the first portion of the alimentary canal that receives food and begins digestion by mechanically breaking up the solid food particles into smaller pieces and mixing them with saliva....
 to the stomach
Stomach

In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
. Dysphagia is distinguished from other symptoms including odynophagia
Odynophagia

Odynophagia is painful swallowing, in the mouth or esophagus. It can occur with or without dysphagia, or difficult swallowing.Odynophagia often results in weight loss....
, which is defined as painful swallowing, and globus
Globus Pharyngis

Globus pharyngis is the persistent sensation of having phlegm or some other sort of obstruction in the throat when there is none. Swallowing can be performed normally, so it is not a true case of dysphagia, but it can become quite irritating....
, which is the sensation of a lump in the throat. A psychogenic dysphagia is known as phagophobia
Phagophobia

Phagophobia is a psychogenic dysphagia, a fear of swallowing. It is expressed in various swallowing complaints without any apparent physical reason detectable by physical inspection and laboratory analyses....
.

It is also worthwhile to refer to the physiology of swallowing
Swallowing

"Gulp" redirects here. For other uses, see Gulp .Swallowing, known scientifically as deglutition, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, into the esophagus, with the shutting of the epiglottis....
 in understanding dysphagia.

Epidemiology

Swallowing disorders can occur in all age groups, resulting from congenital abnormalities, structural damage, and/or medical conditions. Swallowing problems are a common complaint
Complaint

In general use, a complaint is an expression of displeasure, such as poor service at a store, or from a local government, etc. In legal terminology, a complaint is a formal legal document that sets out the basic facts and legal reasons that the filing party believes are sufficient to support a claim against another person, persons, entity...
 among older individuals, and the incidence
Incidence (epidemiology)

Incidence is a measure of the risk of developing some new condition within a specified period of time. Although sometimes loosely expressed simply as the number of new cases during some time period, it is better expressed as a proportion or a rate with a denominator....
 of dysphagia is higher in the elderly, in patients who have had stroke
Stroke

A stroke is the rapidly developing loss of brain function due to a disturbance in the blood supply to the brain. According to the National Stroke Association, a "stroke" occurs when a blood clot blocks and artery or a blood vessel breaks, interrupting blood flow to an area of the brain....
s, and in patients who are admitted to acute care hospitals or chronic care
Chronic care

Chronic care refers to medical care which addresses preexisting or long term illness, as opposed to acute care which is concerned with short term or severe illness of brief duration....
 facilities. Other causes of dysphagia include head and neck cancer
Head and neck cancer

The term head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract, including the lip, oral cavity , nasal cavity, paranasal sinuses, pharynx, and larynx....
 and progressive neurologic diseases like Parkinson's disease
Parkinson's disease

Parkinson's disease is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills and speech, as well as other functions....
, Dementia
Dementia

Dementia is the progressive decline in cognition due to damage or disease in the body beyond what might be expected from normal aging. Although dementia is far more common in the geriatric population, it may occur in any stage of adulthood....
, Multiple sclerosis
Multiple sclerosis

Multiple sclerosis is an autoimmune disease in which the immune system attacks the central nervous system, leading to demyelinating disease. Disease onset usually occurs in young adults, and it is more common in females....
, Multiple system atrophy
Multiple system atrophy

Multiple system atrophy is a rare disease, degenerative neurological disorder. MSA is associated with the degeneration of nerve cells in specific areas of the brain....
, or Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis

Amyotrophic Lateral Sclerosis is a progressive, usually fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement....
. Dysphagia is a symptom of many different causes, which can usually be elicited by a careful history
HIStory

HIStory: Past, Present and Future, Book I is a double album by Michael Jackson, released on June 20, 1995, and is Jackson's ninth. The first disc, named "HIStory Begins" consists of a selection of Jackson's greatest hits from the singer's past fifteen years, while the second, named "HIStory Continues" features new songs, with the...
 by the treating physician
Physician

A physician, medical practitioner, doctor of medicine, or medical doctor practices medicine, and is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease and injury....
 and a formal dysphagia evaluation performed by a speech-language pathologist.

Dysphagia is classified into two major types: oropharyngeal dysphagia
Oropharyngeal dysphagia

Oropharyngeal dysphagia arises from abnormalities of muscles, nerves or structures of the oral cavity, pharynx, and upper esophageal sphincter....
 and esophageal dysphagia
Esophageal dysphagia

Esophageal dysphagia arises from the body of the esophagus, lower esophageal sphincter, or cardia of the stomach. Usually due to mechanical causes or motility problems....
. In some patients, no organic cause for dysphagia can be found, and these patients are defined as having functional dysphagia.

Some patients have limited awareness of their dysphagia, so lack of the symptom does not exclude an underlying disease. When dysphagia goes undiagnosed or untreated, patients are at a high risk of aspiration and subsequent aspiration pneumonia
Aspiration pneumonia

Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials that enter the bronchial tree, usually oral or gastric contents ....
 secondary to food or liquid going the wrong way into the lungs. 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 renal failure.

The gold-standard for diagnosing dysphagia in the United States and Countries of the Commonwealth are via a Modified Barium Swallow Study or Videoflouroscopic Swallow Study (Fluoroscopy
Fluoroscopy

Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope....
). This is a lateral video X-ray that provides objective information on bolus transport, safest consistency of bolus (honey, nectar, thin, pudding, puree, regular), and possible head positioning and/or maneuvers that may facilitate swallow function depending on each individuals anatomy and physiology. This study is performed by a Speech-Language Pathologist and a Radiologist.

Each year, approximately ten million Americans are evaluated for swallowing disorders.

See also

  • Achalasia
    Achalasia

    Achalasia, also known as esophageal achalasia, achalasia cardiae, cardiospasm, and esophageal aperistalsis, is an esophageal motility disorder: The smooth muscle cell layer of the esophagus loses normal peristalsis , and the lower esophageal sphincter fails to relax properly in response to swallowing....
  • Aphagia
    Aphagia

    Aphagia is a medical term referring to the inability or refusal to swallow. It is derived from the Greek root a meaning "not" or "without" and phagia meaning "to eat."...
  • Gastroesophageal reflux disease
    Gastroesophageal reflux disease

    Gastroesophageal reflux disease ', Gastro-oesophageal reflux disease ', Gastric reflux disease, or Acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in...
  • Neurodegenerative disease
    Neurodegenerative disease

    Neurodegenerative disease is a condition in which cells of the brain and spinal cord are lost. The brain and spinal cord are composed of neurons that do different functions such as controlling movements, processing sensory information, and making decisions....
    • Parkinson's disease
      Parkinson's disease

      Parkinson's disease is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills and speech, as well as other functions....
    • Alzheimer's disease
      Alzheimer's disease

      Alzheimer's disease , also called Alzheimer disease, Senile Dementia of the Alzheimer Type or simply Alzheimer's, is the most common form of dementia....
    • Huntington's disease
      Huntington's disease

      Huntington's disease, also called Huntington's Chorea , chorea major, or HD, is a genetics Neurodegenerative disease characterized after onset by uncoordinated, jerky body movements and a decline in some mental abilities....
    • Niemann Pick disease
  • Presbyphagia
    Presbyphagia

    Presbyphagia vs. Dysphagia Although age-related changes place older adults at risk swallowing disorders, an older adult?s swallow is not necessarily an impaired swallow....
  • Pseudodysphagia
  • Speech and language pathology
    Speech and language pathology

    Speech-language pathology is the study of disorders that affect a person's speech, language, cognition, voice, swallowing and the Physical medicine and rehabilitation or corrective treatment of physical and/or cognition deficits/Speech disorder resulting in difficulty with communication and/or swallowing....
  • Stroke
    Stroke

    A stroke is the rapidly developing loss of brain function due to a disturbance in the blood supply to the brain. According to the National Stroke Association, a "stroke" occurs when a blood clot blocks and artery or a blood vessel breaks, interrupting blood flow to an area of the brain....
  • Swallowing
    Swallowing

    "Gulp" redirects here. For other uses, see Gulp .Swallowing, known scientifically as deglutition, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, into the esophagus, with the shutting of the epiglottis....


External links

  • at the World Gastroenterology Organisation (WGO)