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== Medical Therapy of common causes of odynophagia: ==
== Medical Therapy of common causes of odynophagia: ==
Following are few common conditions of odynophagia. These conditions are managed accordingly:
Following are few common conditions of odynophagia. These conditions are managed accordingly:<ref name="pmid29264291">{{cite journal| author=Jalisi S, Jamal BT, Grillone GA| title=Surgical Management of Long-standing Eagle's Syndrome. | journal=Ann Maxillofac Surg | year= 2017 | volume= 7 | issue= 2 | pages= 232-236 | pmid=29264291 | doi=10.4103/ams.ams_53_17 | pmc=5717900 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29264291  }}</ref><ref name="pmid29264290">{{cite journal| author=Jalisi S, Sakai O, Jamal BT, Mardirossian V| title=Features of Prevertebral Disease in Patients Presenting to a Head and Neck Surgery Clinic with Neck Pain. | journal=Ann Maxillofac Surg | year= 2017 | volume= 7 | issue= 2 | pages= 228-231 | pmid=29264290 | doi=10.4103/ams.ams_54_17 | pmc=5717899 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29264290  }}</ref><ref name="pmid29255766">{{cite journal| author=Marques S, Carmo J, Pinto D, Bispo M, Ramos S, Chagas C| title=Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Retrospective Study. | journal=GE Port J Gastroenterol | year= 2017 | volume= 24 | issue= 6 | pages= 262-268 | pmid=29255766 | doi=10.1159/000479232 | pmc=5731150 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29255766  }}</ref><ref name="pmid29206327">{{cite journal| author=Rama-López J, Tomás-Fernandez M, García-Garza C, Martínez-Madrigal M| title=Pharyngeal perforation after anterior cervical spine surgery treated by transoral endoscopic surgery. | journal=Head Neck | year= 2018 | volume= 40 | issue= 2 | pages= E13-E16 | pmid=29206327 | doi=10.1002/hed.25030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29206327  }}</ref><ref name="pmid29198289">{{cite journal| author=Kato MG, Isaac MJ, Gillespie MB, O'Rourke AK| title=The Incidence and Characterization of Globus Sensation, Dysphagia, and Odynophagia Following Surgery for Obstructive Sleep Apnea. | journal=J Clin Sleep Med | year= 2018 | volume= 14 | issue= 1 | pages= 127-132 | pmid=29198289 | doi=10.5664/jcsm.6898 | pmc=5734881 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29198289  }}</ref><ref name="pmid29168645">{{cite journal| author=Teixeira C, Alves AL, Cremers I| title=Esophageal lichen planus: a rare case. | journal=Rev Esp Enferm Dig | year= 2018 | volume= 110 | issue= 1 | pages= 67-68 | pmid=29168645 | doi=10.17235/reed.2017.5332/2017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29168645  }}</ref><ref name="pmid29146495">{{cite journal| author=Chen L, Lai Y, Dong L, Kang S, Chen X| title=Polysaccharides from Citrus grandis L. Osbeck suppress inflammation and relieve chronic pharyngitis. | journal=Microb Pathog | year= 2017 | volume= 113 | issue=  | pages= 365-371 | pmid=29146495 | doi=10.1016/j.micpath.2017.11.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29146495  }}</ref><ref name="pmid29145245">{{cite journal| author=Kim YJ, Park JY, Choi KY, Moon BJ, Lee JK| title=Case reports about an overlooked cause of neck pain: calcific tendinitis of the longus colli: Case reports. | journal=Medicine (Baltimore) | year= 2017 | volume= 96 | issue= 46 | pages= e8343 | pmid=29145245 | doi=10.1097/MD.0000000000008343 | pmc=5704790 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29145245  }}</ref><ref name="pmid29145108">{{cite journal| author=Alamoudi U, Al-Sayed AA, AlSallumi Y, Rigby MH, Taylor SM, Hart RD et al.| title=Acute calcific tendinitis of the longus colli muscle masquerading as a retropharyngeal abscess: A case report and review of the literature. | journal=Int J Surg Case Rep | year= 2017 | volume= 41 | issue=  | pages= 343-346 | pmid=29145108 | doi=10.1016/j.ijscr.2017.10.063 | pmc=5686463 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29145108  }}</ref><ref name="pmid29128948">{{cite journal| author=Sopeña B, Limeres J, García-Caballero L, Diniz-Freitas M, Seoane J, Diz P| title=A Dramatic Case of Odynophagia. | journal=Dysphagia | year= 2018 | volume= 33 | issue= 1 | pages= 133-135 | pmid=29128948 | doi=10.1007/s00455-017-9861-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29128948  }}</ref><ref name="pmid29124648">{{cite journal| author=Fukuda S, Watanabe N, Domen T, Ishioka M, Sawaguchi M, Ohba R et al.| title=A case of esophageal actinomycosis with a unique morphology presenting as a refractory ulcer. | journal=Clin J Gastroenterol | year= 2018 | volume= 11 | issue= 1 | pages= 38-41 | pmid=29124648 | doi=10.1007/s12328-017-0797-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29124648  }}</ref><ref name="pmid29072250">{{cite journal| author=Chi TH, Hung CC, Chen RF, Yuan CH, Chen JC| title=Spontaneous retropharyngeal emphysema: A case report. | journal=Niger J Clin Pract | year= 2017 | volume= 20 | issue= 9 | pages= 1213-1215 | pmid=29072250 | doi=10.4103/njcp.njcp_3_16 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29072250  }}</ref><ref name="pmid29071486">{{cite journal| author=Jovov B, Reed CC, Shaheen NJ, Pruitt A, Ferrell K, Orlando GS et al.| title=Fragments of e-Cadherin as Biomarkers of Non-erosive Reflux Disease. | journal=Dig Dis Sci | year= 2017 | volume=  | issue=  | pages=  | pmid=29071486 | doi=10.1007/s10620-017-4815-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29071486  }}</ref><ref name="pmid29043549">{{cite journal| author=Althuwaini S, Bamehriz F, Aldohayan A, Alshammari W, Alhaidar S, Alotaibi M et al.| title=Prevalence and Predictors of Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy. | journal=Obes Surg | year= 2017 | volume=  | issue=  | pages=  | pmid=29043549 | doi=10.1007/s11695-017-2971-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29043549  }}</ref>


==== Upper respiratory tract infections: ====
==== Upper respiratory tract infections: ====
* Antibiotics
* [[Antibiotics]]
** Cephalosporins,
** [[Cephalosporins]]
** penecillins.
** [[Penicillin|Penicillins]]
** macrolides
** [[Macrolides]]
** Vancomycin
** [[Vancomycin]]
** Anti tuberculosis therapy
** [[Antituberculosis|Antituberculosis therapy]]
* Soothing agents
* Soothing agents
** marshmallow plan
** Marshmallow plan
** Sage  
** [[Sage oil|Sage]]
** echinacea
** [[Echinacea]]
** Apple cider vinegar
** Apple cider vinegar
** Salt water gargle
** Salt water gargle
** Honey
** Honey
** Licorice root
** [[Licorice|Licorice root]]
** Lemon water
** [[Lemon Balm|Lemon]] water
** Ginger root tea
** Ginger root tea
** Coconut oil
** [[Coconut oil]]
** Cinnamon
** [[Cinnamon]]
** Plenty of fluids
** Plenty of fluids
** Chicken soup
** Chicken soup
** Peppermint tea
** Peppermint tea
** Chamomile tea
** Chamomile tea
** Herbal throat lozenges.
** Herbal throat [[lozenges]]


==== Amyotrophic lateral sclerosis: ====
==== [[Amyotrophic lateral sclerosis]]: ====
* Anticholinergics 
* [[Anticholinergics]] 


===== Lower esophageal spasms =====
===== [[Lower esophageal spasms]] =====
* Anticholinergics 
* [[Anticholinergics]] 


* Antispasmodics, [[botulinum toxin]] injection
* [[Antispasmodics]], [[botulinum toxin]] injection
* (lower esophageal spasm)


===== Myasthenia gravis, Polymyositis Scelroderma: =====
===== Myasthenia gravis, Polymyositis, Scelroderma: =====
* Glucocorticoids 
* [[Glucocorticoids]] 


* Muscarinic agents  
* [[Antimuscarinic]] agents  


===== [[Gastroesophageal reflux disease]]: =====
===== [[Gastroesophageal reflux disease]]: =====
* Proton pump inhibitors  
* [[Proton pump inhibitor|Proton pump inhibitors]]


* Promotility agents, weight loss
* Promotility agents, [[weight loss]]
* Avoidance of offending foods
* Avoidance of offending food
* Elevated sleeping
* Elevation of the head of the bed


===== Tumors of esophagus, lung or oral cavity: =====
===== Tumors of esophagus, lung or oral cavity: =====
* Surgical therapy
* [[Surgery|Surgical therapy]]
* Radiation therapy
* [[Radiation therapy]]
* Anti-tumor medication
* Anti-tumor medication
* Soothing agents
* Soothing agents
* NSAIDS
* [[Non-steroidal anti-inflammatory drug|NSAIDS]]
* Morphine
* [[Morphine]]


====== Foreign body: ======
====== Foreign body: ======
* Surgical removal
* Surgical removal
* Propelling agents (Barium swallow as coin in children )
* Propelling agents (barium swallow as coin in children )
* NSAIDS
* [[Non-steroidal anti-inflammatory drug|NSAIDS]]
 
 
'''Approaching patient with Odynophagia'''
 
{{Family tree/start}}
{{Family tree | | | | | | | A01 | | | |A01='''Alarm findings:'''<br>Odynophagia<br>Dysphagia<br>Weight loss<br>Anorexia }}
{{Family tree | | | |,|-|-|-|^|-|-|.| | }}
{{Family tree | | | |!| | | | | | B02 | | |B02='''If present:'''<br>upper gut endoscopy }}
{{Family tree | | | |)|-|-|-|-|-|^|-|.| }}
{{Family tree | | | C01 | | | | | | | C02 | |C01='''If normal'''<br>Proton pump inhibitors<br>therapeutic or empirical|C02=If mucousal abnormality<br>seen than treat }}
{{Family tree | |,|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{Family tree | | D01 | | | | | | | | D02 | | |D01='''If patient benefits'''<br>taper dose and maintain|D02='''If no benefit'''<br>order manomatery }}
{{Family tree | | | | | | | |,|-|-|-|-|+|-|-|-|-|-|.| | }}
{{Family tree | | | | | | | E01 | | | E02 | | | | |!| | |E01='''Manomatery shows'''<br>Achlasia|E02='''Manomatery shows'''<br>Spastic motility disorders<br>Nutcracker esophagus<br>DES<br>Hypertonic LES }}
{{Family tree | | | | | | |!| | | | |!| | | | | | |!| | | }}
{{Family tree | | | | | | F01 | | | |`|-|-|-|-| F02 | |F01='''Treat with'''<br>medicine<br>surgery<br>endoscopic procedure|F02='''Manomatery shows'''<br>Normal tone<br>Trear with pain killers }}
{{Family tree/end}}


==References==
==References==

Latest revision as of 15:52, 26 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sunny Kumar MD [2]

Medical Therapy overview

The treatment of odynophagia depends on it's etiology.

Medical Therapy of common causes of odynophagia:

Following are few common conditions of odynophagia. These conditions are managed accordingly:[1][2][3][4][5][6][7][8][9][10][11][12][13][14]

Upper respiratory tract infections:

Amyotrophic lateral sclerosis:

Lower esophageal spasms
Myasthenia gravis, Polymyositis, Scelroderma:
Gastroesophageal reflux disease:
  • Promotility agents, weight loss
  • Avoidance of offending food
  • Elevation of the head of the bed
Tumors of esophagus, lung or oral cavity:
Foreign body:
  • Surgical removal
  • Propelling agents (barium swallow as coin in children )
  • NSAIDS


Approaching patient with Odynophagia

 
 
 
 
 
 
Alarm findings:
Odynophagia
Dysphagia
Weight loss
Anorexia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If present:
upper gut endoscopy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If normal
Proton pump inhibitors
therapeutic or empirical
 
 
 
 
 
 
If mucousal abnormality
seen than treat
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If patient benefits
taper dose and maintain
 
 
 
 
 
 
 
If no benefit
order manomatery
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Manomatery shows
Achlasia
 
 
Manomatery shows
Spastic motility disorders
Nutcracker esophagus
DES
Hypertonic LES
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treat with
medicine
surgery
endoscopic procedure
 
 
 
 
 
 
 
 
 
Manomatery shows
Normal tone
Trear with pain killers
 
 
 
 
 
 

References

  1. ↑ Jalisi S, Jamal BT, Grillone GA (2017). "Surgical Management of Long-standing Eagle's Syndrome". Ann Maxillofac Surg. 7 (2): 232–236. doi:10.4103/ams.ams_53_17. PMC 5717900. PMID 29264291.
  2. ↑ Jalisi S, Sakai O, Jamal BT, Mardirossian V (2017). "Features of Prevertebral Disease in Patients Presenting to a Head and Neck Surgery Clinic with Neck Pain". Ann Maxillofac Surg. 7 (2): 228–231. doi:10.4103/ams.ams_54_17. PMC 5717899. PMID 29264290.
  3. ↑ Marques S, Carmo J, Pinto D, Bispo M, Ramos S, Chagas C (2017). "Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Retrospective Study". GE Port J Gastroenterol. 24 (6): 262–268. doi:10.1159/000479232. PMC 5731150. PMID 29255766.
  4. ↑ Rama-López J, Tomás-Fernandez M, García-Garza C, Martínez-Madrigal M (2018). "Pharyngeal perforation after anterior cervical spine surgery treated by transoral endoscopic surgery". Head Neck. 40 (2): E13–E16. doi:10.1002/hed.25030. PMID 29206327.
  5. ↑ Kato MG, Isaac MJ, Gillespie MB, O'Rourke AK (2018). "The Incidence and Characterization of Globus Sensation, Dysphagia, and Odynophagia Following Surgery for Obstructive Sleep Apnea". J Clin Sleep Med. 14 (1): 127–132. doi:10.5664/jcsm.6898. PMC 5734881. PMID 29198289.
  6. ↑ Teixeira C, Alves AL, Cremers I (2018). "Esophageal lichen planus: a rare case". Rev Esp Enferm Dig. 110 (1): 67–68. doi:10.17235/reed.2017.5332/2017. PMID 29168645.
  7. ↑ Chen L, Lai Y, Dong L, Kang S, Chen X (2017). "Polysaccharides from Citrus grandis L. Osbeck suppress inflammation and relieve chronic pharyngitis". Microb Pathog. 113: 365–371. doi:10.1016/j.micpath.2017.11.018. PMID 29146495.
  8. ↑ Kim YJ, Park JY, Choi KY, Moon BJ, Lee JK (2017). "Case reports about an overlooked cause of neck pain: calcific tendinitis of the longus colli: Case reports". Medicine (Baltimore). 96 (46): e8343. doi:10.1097/MD.0000000000008343. PMC 5704790. PMID 29145245.
  9. ↑ Alamoudi U, Al-Sayed AA, AlSallumi Y, Rigby MH, Taylor SM, Hart RD; et al. (2017). "Acute calcific tendinitis of the longus colli muscle masquerading as a retropharyngeal abscess: A case report and review of the literature". Int J Surg Case Rep. 41: 343–346. doi:10.1016/j.ijscr.2017.10.063. PMC 5686463. PMID 29145108.
  10. ↑ Sopeña B, Limeres J, García-Caballero L, Diniz-Freitas M, Seoane J, Diz P (2018). "A Dramatic Case of Odynophagia". Dysphagia. 33 (1): 133–135. doi:10.1007/s00455-017-9861-8. PMID 29128948.
  11. ↑ Fukuda S, Watanabe N, Domen T, Ishioka M, Sawaguchi M, Ohba R; et al. (2018). "A case of esophageal actinomycosis with a unique morphology presenting as a refractory ulcer". Clin J Gastroenterol. 11 (1): 38–41. doi:10.1007/s12328-017-0797-1. PMID 29124648.
  12. ↑ Chi TH, Hung CC, Chen RF, Yuan CH, Chen JC (2017). "Spontaneous retropharyngeal emphysema: A case report". Niger J Clin Pract. 20 (9): 1213–1215. doi:10.4103/njcp.njcp_3_16. PMID 29072250.
  13. ↑ Jovov B, Reed CC, Shaheen NJ, Pruitt A, Ferrell K, Orlando GS; et al. (2017). "Fragments of e-Cadherin as Biomarkers of Non-erosive Reflux Disease". Dig Dis Sci. doi:10.1007/s10620-017-4815-4. PMID 29071486.
  14. ↑ Althuwaini S, Bamehriz F, Aldohayan A, Alshammari W, Alhaidar S, Alotaibi M; et al. (2017). "Prevalence and Predictors of Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy". Obes Surg. doi:10.1007/s11695-017-2971-4. PMID 29043549.

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