Causes of dysphagia

Document introduction of content: Definition, introduction and key points, disease burden and epidemiology, causes of dysphagia, clinical diagnosis, treatment options, references, useful web sites and guidelines.

14p vovanvovan2013 13-05-2016 38 1   Download

Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant disease that usually manifests itself within the fifth decade. The most prom-inent symptoms are progressive ptosis, dysphagia, and proximal limb mus-cle weakness. The disorder is caused by trinucleotide (GCG) expansions in the N-terminal part of the poly(A)-binding protein 1 (PABPN1) that result in the extension of a 10-alanine segment by up to seven more alanines.

10p inspiron33 23-03-2013 49 4   Download

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Diffuse idiopathic skeletal hyperostosis as an overlooked cause of dysphagia: a case report

3p dauphong1 21-12-2011 56 4   Download

Sepsis with Skin Manifestations (See also Chap. 18) Maculopapular rashes may reflect early meningococcal or rickettsial disease but are usually associated with nonemergent infections. Exanthems are usually viral. Primary HIV infection commonly presents with a rash that is typically maculopapular and involves the upper part of the body but can spread to the palms and soles. The patient is usually febrile and can have lymphadenopathy, severe headache, dysphagia, diarrhea, myalgias, and arthralgias.

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Chest pain with dysphagia occurs in DES and related motor disorders. Chest pain resembling DES may occur in esophageal obstruction due to a large bolus. A prolonged history of heartburn and reflux preceding dysphagia indicates peptic stricture. A history of prolonged nasogastric intubation, ingestion of caustic agents, ingestion of pills without water, previous radiation therapy, or associated mucocutaneous diseases may provide the cause of esophageal stricture. If odynophagia is present, candidal, herpes, or pill-induced esophagitis should be suspected.

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Oropharyngeal motor dysphagia results from impairment of the voluntary effort required in bolus preparation or neuromuscular disorders affecting bolus preparation, initiation of the swallowing reflex, timely passage of food through the pharynx, and prevention of entry of food into the nasal and the laryngeal opening. Paralysis of the suprahyoid muscles leads to loss of opening of the UES and severe dysphagia. Because each side of the pharynx is innervated by ipsilateral nerves, a unilateral lesion of motor neurons leads to unilateral pharyngeal paralysis.

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Pathophysiology of Dysphagia Based on anatomic site of involvement, dysphagia may be divided into oral, pharyngeal, and esophageal dysphagia. Normal transport of an ingested bolus through the swallowing passage depends on the size of the ingested bolus and size of the lumen, the force of peristaltic contraction, and deglutitive inhibition, including normal relaxation of UES and LES during swallowing.

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