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| {{Search infobox}}
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| {{SK}} painful swallowing | | '''For patient information on this topic, click [[odynophagia (patient information)|here]].''' |
| | {{Odynophagia}} |
| | {{CMG}}; {{AE}} {{SKA}} |
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| ==Overview==
| | {{SK}} Painful swallowing, Pain during swallowing, Odenophagia, Odinophagia, Odenophagia. |
| '''Odynophagia''' is defined as painful swallowing.
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| == Causes== | | ==[[Odynophagia overview|Overview]]== |
| ===Common Causes=== | | ==[[Odynophagia historical perspective|Historical Perspective]]== |
| * [[Upper respiratory tract infections]]
| | ==[[Odynophagia pathophysiology|Pathophysiology]]== |
| * [[Achalasia cardia]]
| | ==[[Odynophagia causes|Causes]]== |
| * [[Scleroderma]]
| | ==[[Odynophagia differential diagnosis|Differentiating Odynophagia from other Conditions]]== |
| * [[Zenkers diverticulum]]
| | ==[[Odynophagia epidemiology and demographics|Epidemiology and Demographics]]== |
| * [[Esophageal cancer]]
| | ==[[Odynophagia risk factors|Risk Factors]]== |
| * [[Myasthenia gravis]]
| | ==[[Odynophagia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| * [[Tonsillitis]]
| | ==Diagnosis== |
| ===Causes by Organ System=== | | [[Odynophagia history and symptoms|History and Symptoms]] | [[Odynophagia physical examination|Physical Examination]] | [[Odynophagia laboratory findings|Laboratory Findings]] | [[Odynophagia electrocardiogram|Electrocardiogram]] | [[Odynophagia chest x ray|Chest X Ray]] | [[Odynophagia CT|CT]] | [[Odynophagia MRI|MRI]] | [[Odynophagia echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Odynophagia other imaging findings|Other Imaging Findings]] | [[Odynophagia other diagnostic studies|Other Diagnostic Studies]] |
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| ===Causes in Alphabetical Order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>=== | | ==Treatment== |
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| * [[Abscess]]es
| | [[Odynophagia medical therapy|Medical Therapy]] | [[Odynophagia surgery|Surgery]] | [[Odynophagia primary prevention|Primary Prevention]] | [[Odynophagia secondary prevention|Secondary Prevention]] | [[Odynophagia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Odynophagia future or investigational therapies|Future or Investigational Therapies]] |
| * [[Achalasia]]
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| * [[Aerophagia]]
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| * [[Agranulocytosis]]
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| * [[Alcoholism]]
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| * Allergic swelling
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| * [[Amyloidosis]]
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| * [[Amyotrophic Lateral Sclerosis]] (ALS)
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| * Angina tonsillaris
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| * Anxiety disorders
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| * [[Aortic aneurysm]]
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| * Aspiration of foreign body
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| * [[Barret's Syndrome]]
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| * [[Behcet's Syndrome]]
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| * [[Botulism]]
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| * [[Brainstem stroke]]
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| * [[Bronchial carcinoma]]
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| * [[Bulbar palsy]]
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| * [[Candidiasis]]
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| * Cascade stomach
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| * Central hypoglossal nerve paralysis
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| * Central vagal nucleus lesion
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| * [[Cerebrovascular accident]] ([[CVA]])
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| * [[Chagas Disease]]
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| * Chemical burns
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| * [[CREST syndrome]] ('''c'''alcinosis '''r'''aynaud's phenomenon '''e'''sophagus '''s'''clerodactyly '''t'''elangiectasias)
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| * [[Cytomegalovirus]] ([[CMV]])
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| * [[Dermatomyositis]]
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| * [[Diabetic neuropathy]]
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| * [[Diphtheria]]
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| * [[Diverticulum]]
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| * [[Left Atrial Enlargement|Enlarged left atrium]]
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| * [[Esophageal cancer]]
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| * Esophageal [[Crohn's disease]]
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| * [[Esophageal diverticulum]]
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| * Esophageal moniliasis
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| * Esophageal [[sarcoidosis]]
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| * [[Esophageal spasm]]
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| * Esophageal trauma
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| * [[Esophagotracheal fistula]]
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| * Extreme spinal curvature
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| * Fibrosis
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| * Food bolus
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| * Gastric tumors
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| * [[Gastritis]]
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| * [[Gastroparesis]]
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| * [[Global hystericus]]
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| * Globus syndrome
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| * [[Goiter]]
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| * [[Graft versus host reaction]]
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| * [[Guillain-Barre Syndrome]]
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| * [[Herpangina]]
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| * [[Herpes simplex virus]] ([[HSV]])
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| * [[Hiatal hernia]]
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| * [[Huntington's chorea]]
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| * [[Hyperthyroidism]]
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| * [[Hypokalemia]]
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| * [[Hypothyroidism]]
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| * Idiopathic [[human immunodeficiency virus]][[HIV]] ulcers
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| * Impaired sensitivity in the larynx
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| * Intramural pseudodiverticulosis
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| * [[Laryngeal cancer]]
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| * Lateral funiculus angina
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| * [[Leiomyoma]]
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| * [[Ludwig's angina]]
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| * Lymph granulomatosis
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| * [[Lymphadenopathy]]
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| * Medication-induced [[esophagitis]]
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| * [[Mononucleosis]]
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| * [[Multiple Sclerosis]]
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| * [[Mumps]]
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| * [[Myasthenia Gravis]]
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| * Neoplastic (external compression)
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| * [[Nutcracker esophagus]]
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| * Oral [[candidiasis]]
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| * Osteophytes
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| * Palatoplegia after damage to the vagal nerve or the accessory nerve
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| * [[Paraneoplastic syndrome]]
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| * [[Parkinson's Disease]]
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| * Peptic stenosis
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| * [[Peripheral neuropathy]]
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| * Peripheral tongue paralysis with lesions of the hypoglossal nerve
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| * [[Pharyngitis]]
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| * Pleural and pericardial causes
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| * [[Plummer-Vinson Syndrome]]
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| * [[Poliomyelitis]]
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| * [[Polyradiculitis]]
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| * [[Pseudoachalasia]]
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| * [[Pseudobulbar paralysis]]
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| * [[Pyloric stenosis]]
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| * [[Rabies]]
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| * [[Radiation esophagitis]]
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| * [[Reflux esophagitis]]
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| * [[Rheumatoid Arthritis]]
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| * [[Scarlet Fever]]
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| * [[Schatzki ring]]
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| * [[Scleroderma]]
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| * [[Stevens-Johnson Syndrome]]
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| * [[Stomatitis]]
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| * [[Syringobulbia]]
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| * [[Systemic Lupus Erythematosus]]
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| * [[Tetanus]]
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| * Tonsillar abscess
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| * [[Typhoid fever]] angina
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| * Vascular abnormality
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| * [[Vincent's angina]]
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| * [[Zenker's Diverticulum]]
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| ==Symptoms to Differentiate Odynophagia From== | | ==Case Studies== |
| * [[Dysphagia]] is defined as difficulty in swallowing
| | [[Odynophagia case study one|Case #1]] |
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| == Diagnosis ==
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| === History and Symptoms ===
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| A directed history should be performed to characterize the following:
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| * Onset
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| * Severity
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| * Duration
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| * Dysphagia with liquids versus solids
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| * Psychiatric history
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| * Prior episodes
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| * Substance exposure
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| * History of neck and head problems
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| === Laboratory Findings ===
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| ==== Electrolyte and Biomarker Studies ====
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| * Creatinine phosphokinase (CPK) can be used to rule out cardiac ischemia as a cause.
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| === Electrocardiogram ===
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| Can be used to assess for left atrial enlargement.
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| === Chest X Ray ===
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| Can used to rule out lung cancer and other mass lesions as well as left atrial enlargement.
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| === MRI and CT ===
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| * MRI of brain can be used to exclude CVA and mass lesions of the head and neck.
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| === Echocardiography or Ultrasound ===
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| Can be used to rule out an aneurysm or left atrial enlargement as a cause.
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| === Other Diagnostic Studies ===
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| * [[Esophagogastroduodenoscopy]] (OGD)
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| * [[Biopsy]]
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| * [[Barium swallow]]
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| * [[Electromyogram]] ([[EMG]])
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| * Nerve conduction tests
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| * Esophageal manometry
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| == Treatment ==
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| * Endoscopy (acute and chronic mechanical obstructions)
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| * Speech therapy (ALS and stroke patients)
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| == Pharmacotherapy ==
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| * Proton pump inhibitors or promotility agents, weight loss, avoidance of offending foods (gastroesophageal reflux disease)
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| * Anticholinergics (ALS, stroke, lower esophageal spasms)
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| * Muscarinic agents (myasthenia gravis)
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| * Glucocorticoids (myasthenia gravis and polymyositis)
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| * Antispasmodics, botulinum toxin injection (lower esophageal spasm)
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| == Surgery and Device Based Therapy ==
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| * Thoracic surgery, possible balloon dilation (chronic mechanical obstruction)
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| == References ==
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| {{Reflist|2}}
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| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Musculoskeletal Disease]] | | [[Category:Musculoskeletal Disease]] |
| | [[Category:Symptoms]] |
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |
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