Dysphagia - wikipedia Dysphagia Not to be confused with Dysphasia. Dysphagia Classification and external resources Specialty Gastroenterology ICD - 10 R13 ICD - 9 - CM 438.82, 787.2 DiseasesDB 17942 MedlinePlus 003115 eMedicine pmr / 194 Patient UK Dysphagia MeSH D003680 ( edit on Wikidata ) Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under `` symptoms and signs '' in ICD - 10, the term is sometimes used as a condition in its own right. People with dysphagia are sometimes unaware of having it. It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of pharyngeal sensation, or various other inadequacies of the swallowing mechanism. Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing, and globus, which is the sensation of a lump in the throat. A person can have dysphagia without odynophagia ( dysfunction without pain ), odynophagia without dysphagia ( pain without dysfunction ), or both together. A psychogenic dysphagia is known as phagophobia. Contents 1 Signs and symptoms 1.1 Complications 2 Causes 2.1 Classification 3 Diagnostic approach 3.1 Differential diagnosis 4 Treatments 5 Epidemiology 6 Etymology 7 See also 8 References 9 External links Signs and symptoms 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 pulmonary aspiration and subsequent aspiration pneumonia secondary to food or liquids 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. Some signs and symptoms of oropharyngeal dysphagia include difficulty controlling food in the mouth, inability to control food or saliva in the mouth, difficulty initiating a swallow, coughing, choking, frequent pneumonia, unexplained weight loss, gurgly or wet voice after swallowing, nasal regurgitation, and dysphagia ( patient complaint of swallowing difficulty ). When asked where the food is getting stuck, patients will often point to the cervical ( neck ) region as the site of the obstruction. The actual site of obstruction is always at or below the level at which the level of obstruction is perceived. The most common symptom of esophageal dysphagia is the inability to swallow solid food, which the patient will describe as ' becoming stuck ' or ' held up ' before it either passes into the stomach or is regurgitated. Pain on swallowing or odynophagia is a distinctive symptom that can be highly indicative of carcinoma, although it also has numerous other causes that are not related to cancer. Achalasia is a major exception to usual pattern of dysphagia in that swallowing of fluid tends to cause more difficulty than swallowing solids. In achalasia, there is idiopathic destruction of parasympathetic ganglia of the Auerbach 's ( Myenteric ) plexus of the entire esophagus, which results in functional narrowing of the lower esophagus, and peristaltic failure throughout its length. Complications Complications of dysphagia may include aspiration, pneumonia, dehydration, and weight loss. Causes Classification Dysphagia is classified into the following major types : Oropharyngeal dysphagia Esophageal and obstructive dysphagia Neuromuscular symptom complexes Functional dysphagia is defined in some patients as having no organic cause for dysphagia that can be found. Following table enumerates possible causes of dysphagia : Location Cause Oral dysphagia Tonsillitis Peritonsillar abscess Stomatitis Tongue cancer Paralysis of soft palate, usually due to diphtheria in children and bulbar palsy in adults Bell 's palsy Xerostomia Pharyngeal dysphagia Lumen : Impacted foreign body Wall : Pharyngitis Paterson - Kelly syndrome Pharyngeal spasms Malignant neoplasm Outside the wall : Retropharyngeal abscess Lymphadenopathy of cervical lymph nodes Thyroid malignancy Esophageal dysphagia Lumen Impacted foreign body Wall : Esophageal atresia Benign strictures, due to reflux esophagitis, swallowed corrosives, tuberculosis, scleroderma, and radiotherapy, systemic sclerosis Spasms, due to achalasia, Paterson - Kelly syndrome, esophageal webs, and esophageal rings Neoplasms, such as esophageal cancer, esophageal leimomyoma Nervous disorders, such as bulbar palsy, pseudobulbar palsy, post-vagotomy, myasthenia gravis Crohn 's disease Candida esophagitis Eosinophilic esophagitis Outside the wall : Retrosternal goitre Malignancy Thyroid swelling Zenker 's diverticulum Aortic aneurysm Mediastinal growth Dysphagia lusoria Periesophagitis Hiatus hernia Tight hiatus repairs Diagnostic approach The gold - standard for diagnosing oropharyngeal dysphagia in countries of the Commonwealth are via a modified barium swallow study or videofluoroscopic swallow study ( fluoroscopy ). This is a lateral video ( and AP in some cases ) X-ray that provides objective information on bolus transport, safest consistency of bolus ( different consistencies including honey, nectar, thin, pudding, puree, regular ), and possible head positioning and / or maneuvers that may facilitate swallow function depending on each individual 's anatomy and physiology. In Zenker 's diverticulum, barium meal first fills the pouch, then overflows from top. In achalasia, it shows `` bird - beak '' tapering of distal esophagus, this is also discirbed as a `` rat 's tail '' appearance. Reflux can be demonstrated in fluorscopy. In strictures, meal is initially arrested above stricture, then gradually trickles down. Esophagoscopy and laryngoscopy can give direct view of lumens. Chest radiograph may show air - fluid level in mediastinum. Pott 's disease and calcified aneurysms of aorta can be easily diagnosed. Esophageal motility study is useful in cases of achalasia and diffuse esophageal spasms. Exfoliative cytology can be performed on esophageal lavage obtained by esophagoscopy. It can detect malignant cells in early stage. Ultrasonography and CT scan are not very useful in finding cause of dysphagia ; but can detect masses in mediastinum and aortic aneurysms. FEES ( Fibreoptic endoscopic evaluation of swallowing ), sometimes with sensory evaluation, is done usually by a Medical Speech Pathologist or Deglutologist. This procedure involves the patient eating different consistencies as above. Swallowing sounds and vibrations could be potentially used for dysphagia screening, but these approaches are in the early research stages. Differential diagnosis All causes of dysphagia are considered as differential diagnoses. Some common ones are : Esophageal atresia Paterson - Kelly syndrome Zenker 's diverticulum Esophageal varices Benign strictures Achalasia Esophagial diverticula Scleroderma Diffuse esophageal spasm Polymyositis Webs and rings Esophageal cancer Eosinophilic esophagitis Hiatus hernia, especially paraesophageal type Dysphagia lusoria Gastroesophageal reflux Parkinson 's disease Multiple Sclerosis Esophageal dysphagia is almost always caused by disease in or adjacent to the esophagus but occasionally the lesion is in the pharynx or stomach. In many of the pathological conditions causing dysphagia, the lumen becomes progressively narrowed and indistensible. Initially only fibrous solids cause difficulty but later the problem can extend to all solids and later even to liquids. Patients with difficulty swallowing may benefit from thickened fluids if the person is more comfortable with those liquids, although, so far, there are no scientific study that proves that those thickened liquids are beneficial. Dysphagia may manifest as the result of autonomic nervous system pathologies including stroke and ALS, or due to rapid iatrogenic correction of an electrolyte imbalance. Treatments There are many ways to treat dysphagia, such as swallowing therapy, dietary changes, feeding tubes, certain medications, and surgery. Treatments for dysphagia will be managed by a group of specialists known as a multidisciplinary team. Minitablets make medications easier to swallow. 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 among older individuals, and the incidence of dysphagia is higher in the elderly, in patients who have had strokes, and in patients who are admitted to acute care hospitals or chronic care facilities. Dysphagia is a symptom of many different causes, which can usually be elicited through a careful history by the treating physician. A formal oropharyngeal dysphagia evaluation is performed by a medical speech pathologist or occupational therapist. Etymology The word `` dysphagia '' is derived from the Greek dys meaning bad or disordered, and the root phag - meaning `` eat ''. See also MEGF10 Pseudodysphagia, an irrational fear of swallowing or choking Aphagia References Jump up ^ Smithard DG, Smeeton NC, Wolfe CD ( 2007 ). `` Long - term outcome after stroke : does dysphagia matter ? ''. Age Ageing. 36 ( 1 ) : 90 -- 4. doi : 10.1093 / ageing / afl149. PMID 17172601. Jump up ^ Brady A ( 2008 ). `` Managing the patient with dysphagia ''. Home Healthc Nurse. 26 ( 1 ) : 41 -- 6 ; quiz 47 -- 8. doi : 10.1097 / 01. NHH. 0000305554.40220. 6d. PMID 18158492. Jump up ^ `` ICD - 10 : ''. Retrieved 2008 - 02 - 23. Jump up ^ Boczko F ( 2006 ). `` Patients ' awareness of symptoms of dysphagia ''. J Am Med Dir Assoc. 7 ( 9 ) : 587 -- 90. doi : 10.1016 / j. jamda. 2006.08. 002. PMID 17095424. Jump up ^ `` Dysphagia ''. University of Virginia. Archived from the original on 2004 - 07 - 09. Retrieved 2008 - 02 - 24. Jump up ^ `` Swallowing Disorders - Symptoms of Dysphagia ''. New York University School of Medicine. Archived from the original on 2007 - 11 - 14. Retrieved 2008 - 02 - 24. Jump up ^ Parker C, Power M, Hamdy S, Bowen A, Tyrrell P, Thompson DG ( 2004 ). `` Awareness of dysphagia by patients following stroke predicts swallowing performance ''. Dysphagia. 19 ( 1 ) : 28 -- 35. doi : 10.1007 / s00455 - 003 - 0032 - 8. PMID 14745643. Jump up ^ Rosenvinge SK, Starke ID ( 2005 ). `` Improving care for patients with dysphagia ''. Age Ageing. 34 ( 6 ) : 587 -- 93. doi : 10.1093 / ageing / afi187. PMID 16267184. Jump up ^ Sleisenger, Marvin H. ; Feldman, Mark ; Friedman, Lawrence M. ( 2002 ). Sleisenger & Fordtran 's Gastrointestinal & Liver Disease, 7th edition. Philadelphia, PA : W.B. Saunders Company. Chapter 6, p. 63. ISBN 0 - 7216 - 0010 - 7. Jump up ^ `` Dysphagia ''. University of Texas Medical Branch. Archived from the original on 2008 - 03 - 06. Retrieved 2008 - 02 - 23. ^ Jump up to : Logemann, Jeri A. ( 1998 ). Evaluation and treatment of swallowing disorders. Austin, Tex : Pro-Ed. ISBN 0 - 89079 - 728 - 5. Jump up ^ Spieker, Michael R. ( 15 June 2000 ). `` Evaluating Dysphagia ''. American Family Physician. 61 ( 12 ) : 3639 -- 3648. PMID 10892635. Jump up ^ Dudik JM, Coyle JL, Sejdić E ( 2015 ). `` Dysphagia screening : Contributions of cervical auscultation signals and modern signal processing techniques ''. IEEE Transactions on Human - Machine Systems. 45 ( 4 ) : 465 -- 477. doi : 10.1109 / thms. 2015.2408615. CS1 maint : Multiple names : authors list ( link ) Jump up ^ Edmiaston J, Connor LT, Loehr L, Nassief A ( Jul 2010 ). `` Validation of a dysphagia screening tool in acute stroke patients ''. Am J Crit Care. 19 ( 4 ) : 357 -- 64. doi : 10.4037 / ajcc2009961. PMC 2896456. PMID 19875722. CS1 maint : Multiple names : authors list ( link ) Jump up ^ Noh EJ, Park MI, Park SJ, Moon W, Jung HJ ( Jul 2010 ). `` A case of amyotrophic lateral sclerosis presented as oropharyngeal Dysphagia ''. J Neurogastroenterol Motil. 16 ( 3 ) : 319 -- 22. doi : 10.5056 / jnm. 2010.16. 3.319. PMC 2912126. PMID 20680172. CS1 maint : Multiple names : authors list ( link ) Jump up ^ Martin RJ ( Sep 2004 ). `` Central pontine and extrapontine myelinolysis : the osmotic demyelination syndromes ''. J Neurol Neurosurg Psychiatry. 75 Suppl 3 : iii22 -- 8. doi : 10.1136 / jnnp. 2004.045906. PMC 1765665. PMID 15316041. Jump up ^ `` Minitablets : Manufacturing, Characterization Methods, and Future Opportunities ''. www.americanpharmaceuticalreview.com. Retrieved 2017 - 11 - 13. Jump up ^ Shamburek RD, Farrar JT ( 1990 ). `` Disorders of the digestive system in the elderly ''. N. Engl. J. Med. 322 ( 7 ) : 438 -- 43. doi : 10.1056 / NEJM199002153220705. PMID 2405269. Jump up ^ `` When the Meal Wo n't Go Down ''. New York Times. April 21, 2010. Retrieved July 27, 2014. Jump up ^ Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R ( 2005 ). `` Dysphagia after stroke : incidence, diagnosis, and pulmonary complications ''. Stroke. 36 ( 12 ) : 2756 -- 63. doi : 10.1161 / 01. STR. 0000190056.76543. eb. PMID 16269630. Jump up ^ Ingelfinger FJ, Kramer P, Soutter L, Schatzki R ( 1959 ). `` Panel discussion on diseases of the esophagus ''. Am. J. Gastroenterol. 31 ( 2 ) : 117 -- 31. PMID 13617241. External links Dysphagia Research Society National Foundation of Swallowing Disorders Dysphagia at Curlie ( based on DMOZ ) Overview of Feeding Problems in Children Dysphagia Guideline at the World Gastroenterology Organisation ( WGO ) Speech Language Pathology Scope of Practice American Speech - Language - Hearing Association Swallowing and Feeding Symptoms and signs : digestive system and abdomen ( R10 -- R19, 787,789 ) Upper Nausea Vomiting Heartburn Aerophagia Dysphagia oropharyngeal esophageal Odynophagia Halitosis Xerostomia Hypersalivation Burping Wet burp Defaecation Flatulence Fecal incontinence Encopresis Blood : Fecal occult blood Rectal tenesmus Constipation Obstructed defecation Diarrhea Rectal discharge Psoas sign Obturator sign Rovsing 's sign Hamburger sign Heel tap sign Aure - Rozanova 's sign Dunphy sign Alder 's sign Lockwood 's sign Rosenstein 's sign Abdomen Abdominal pain Acute abdomen Colic Baby colic Abdominal guarding Rebound tenderness Abdominal distension Bloating Ascites Tympanites Shifting dullness Bulging flanks Fluid wave test Abdominal mass Hepatosplenomegaly Hepatomegaly Splenomegaly Jaundice Mallet - Guy sign Puddle sign GND : 4125110 - 6 NDL : 00576682 Retrieved from `` https://en.wikipedia.org/w/index.php?title=Dysphagia&oldid=812199421 '' Categories : Symptoms and signs : Digestive system and abdomen Gastrointestinal tract disorders Hidden categories : CS1 maint : Multiple names : authors list Infobox medical condition Articles with DMOZ links Wikipedia articles with GND identifiers Talk Contents About Wikipedia Azərbaycanca Беларуская Български Bosanski Català Čeština Deutsch Eesti Español فارسی Français 한국어 Hrvatski Bahasa Indonesia Italiano Кыргызча Bahasa Melayu 日本 語 Polski Português Русский Српски / srpski Srpskohrvatski / српскохрватски Suomi Svenska தமிழ் Türkçe Українська 中文 Edit links This page was last edited on 26 November 2017, at 15 : 54. 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Question: what is the difference between dysphagia and odynophagia
Answer: difficulty