|
|
| (23 intermediate revisions by 4 users not shown) |
| Line 1: |
Line 1: |
| {{Search infobox}}
| | __NOTOC__ |
| {{CMG}}; {{AE}} {{ADI}}
| |
|
| |
|
| {{SK}} painful swallowing, pain during swallowing | | '''For patient information on this topic, click [[odynophagia (patient information)|here]].''' |
| | {{Odynophagia}} |
| | {{CMG}}; {{AE}} {{SKA}} |
|
| |
|
| ==Overview==
| | {{SK}} Painful swallowing, Pain during swallowing, Odenophagia, Odinophagia, Odenophagia. |
| '''Odynophagia''' is defined as painful swallowing.
| |
|
| |
|
| == 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]] |
| {|style="width:80%; height:100px" border="1"
| |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aortic aneurysm]], [[Double aortic arch]], [[Enlarged left atrium]], [[Mediastinitis]], [[Mitral valve stenosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Chemical / poisoning'''
| |
| |bgcolor="Beige"| [[Botulism]], [[Chemical burns]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dermatologic'''
| |
| |bgcolor="Beige"| [[Scleroderma]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Drug Side Effect'''
| |
| |bgcolor="Beige"| [[Stevens-Johnson Syndrome]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ear Nose Throat'''
| |
| |bgcolor="Beige"| [[Cricopharyngeal spasm]], [[Epiglottitis]], [[Esophagotracheal fistula]], [[Glossitis]], [[Goiter]], [[Gum disease]], [[Laryngitis]], [[Oral submucous fibrosis]], [[Oral ulcers]], [[Palatoplegia]], [[Stomatitis]], [[Zenker's Diverticulum]], [[Herpangina]], [[Retropharyngeal abscess ]], [[Palate cancer]], [[Supraglottic laryngeal cancer ]], [[Xerostomia]]
| |
| |- | |
| |-bgcolor="LightSteelBlue"
| |
| | '''Endocrine'''
| |
| |bgcolor="Beige"| [[Diabetic neuropathy]], [[Hyperthyroidism]], [[Hypothyroidism]], [[Riedel thyroiditis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Environmental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Gastroenterologic'''
| |
| |bgcolor="Beige"| [[Achalasia]], [[Barrett's oesophagus]], [[Diverticulum]], [[Esophageal achalasia]], [[Esophageal atresia]], [[Esophageal spasm]], [[Esophageal stricture ]], [[Esophagitis ]], [[Fibrosis]], [[Gastritis]], [[Gastroesophageal reflux]], [[Intramural pseudodiverticulosis]], [[Peptic stenosis]], [[Schatzki ring]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Crohn's disease]], [[Eosinophilic esophagitis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Genetic'''
| |
| |bgcolor="Beige"| [[Opitz-Frias syndrome]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Hematologic'''
| |
| |bgcolor="Beige"| [[Agranulocytosis]], [[Lymphadenopathy]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Iatrogenic'''
| |
| |bgcolor="Beige"| [[Radiation esophagitis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Infectious Disease'''
| |
| |bgcolor="Beige"| [[Abscesses]], [[Acute pharyngitis ]], [[Adenoiditis]], [[Angina tonsillaris]], [[Candidiasis]], [[Chagas Disease]], [[Cytomegalovirus ]], [[Diphtheria]], [[Esophageal moniliasis]], [[Flu]], [[Herpangina]], [[Herpes simplex virus (HSV)]], [[Herpes stomatitis ]], [[HIV/AIDS]], [[Mononucleosis]], [[Mumps]], [[Oral candidiasis]], [[Paracoccidioidomycosis]], [[Pharyngitis]], [[Poliomyelitis]], [[Rabies]], [[Reflux esophagitis]], [[Respiratory tract infections ]], [[Retropharyngeal abscess ]], [[Scarlet Fever]], [[Tetanus]], [[Tonsillar abscess]], [[Tooth infection]], [[Typhoid fever]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Musculoskeletal / Ortho'''
| |
| |bgcolor="Beige"| [[Elongated styloid process]], [[Extreme spinal curvature]], [[Global hystericus]], [[Schatzki ring]], [[Leiomyoma]], [[Dermatomyositis]], [[Myasthenia Gravis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Neurologic'''
| |
| |bgcolor="Beige"| [[Amyotrophic Lateral Sclerosis (ALS)]], [[Brainstem stroke]], [[Bulbar palsy]], [[Central hypoglossal nerve paralysis]], [[Central vagal nucleus lesion]], [[Cerebrovascular accident]], [[Guillain-Barre syndrome]], [[Huntington's chorea]], [[Multiple Sclerosis]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Neuroferritinopathy]], [[Peripheral neuropathy]], [[Polyradiculitis]], [[Syringobulbia]], [[Vagal disorder]], [[Diabetic neuropathy]], [[Poliomyelitis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Nutritional / Metabolic'''
| |
| |bgcolor="Beige"| [[Gaucher's disease]], [[Plummer-Vinson Syndrome]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Obstetric/Gynecologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Oncologic'''
| |
| |bgcolor="Beige"| [[Bronchial carcinoma]], [[Carcinoma of the vocal tract ]], [[Carotid body tumor]], [[Esophageal cancer]], [[Gastric tumors]], [[Hypopharyngeal cancer ]], [[Laryngeal cancer]], [[Leiomyoma]], [[Oral cancer ]], [[Palate cancer]], [[Paraneoplastic syndrome]], [[Supraglottic laryngeal cancer ]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Opthalmologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Overdose / Toxicity'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Psychiatric'''
| |
| |bgcolor="Beige"| [[Anxiety disorders]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Pulmonary'''
| |
| |bgcolor="Beige"| [[Bronchial carcinoma]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Renal / Electrolyte'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Rheum / Immune / Allergy'''
| |
| |bgcolor="Beige"| [[Allergic swelling]], [[Amyloidosis]], [[Behcet's Syndrome]], [[CREST syndrome ]], [[Crohn's disease]], [[Dermatomyositis]], [[Eosinophilic esophagitis]], [[Esophageal sarcoidosis]], [[Graft versus host reaction]], [[Inclusion body myositis]], [[Myasthenia Gravis]], [[Parkinson's Disease]], [[Riedel thyroiditis]], [[Rheumatoid Arthritis]], [[Scleroderma]], [[Systemic Lupus Erythematosus]], [[Systemic sclerosis]], [[Xerostomia]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Sexual'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Trauma'''
| |
| |bgcolor="Beige"| [[Esophageal trauma]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Urologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Miscellaneous'''
| |
| |bgcolor="Beige"| [[Alcoholism]], [[Aspiration of foreign body]]
| |
| |-
| |
| |}
| |
|
| |
|
| ===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== |
| {{MultiCol}}
| |
| * [[Abscesses]]
| |
| * [[Achalasia]]
| |
| * [[Acute pharyngitis ]]
| |
| * [[Adenoiditis]]
| |
| * [[Agranulocytosis]]
| |
| * [[Alcoholism]]
| |
| * [[Allergic swelling]]
| |
| * [[Amyloidosis]]
| |
| * [[Amyotrophic Lateral Sclerosis (ALS)]]
| |
| * [[Angina tonsillaris]]
| |
| * [[Anxiety disorders]]
| |
| * [[Aortic aneurysm]]
| |
| * [[Aspiration of foreign body]]
| |
| * [[Barrett's oesophagus]]
| |
| * [[Behcet's Syndrome]]
| |
| * [[Botulism]]
| |
| * [[Brainstem stroke]]
| |
| * [[Bronchial carcinoma]]
| |
| * [[Bulbar palsy]]
| |
| * [[Candidiasis]]
| |
| * [[Carcinoma of the vocal tract ]]
| |
| * [[Carotid body tumor]]
| |
| * [[Central hypoglossal nerve paralysis]]
| |
| * [[Central vagal nucleus lesion]]
| |
| * [[Cerebrovascular accident]]
| |
| * [[Chagas Disease]]<ref>http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002348/</ref>
| |
| * [[Chemical burns]]
| |
| * [[CREST syndrome ]]
| |
| * [[Cricopharyngeal spasm]]
| |
| * [[Crohn's disease]]
| |
| * [[Cytomegalovirus ]]
| |
| * [[Dermatomyositis]]
| |
| * [[Diabetic neuropathy]]
| |
| * [[Diphtheria]]
| |
| * [[Diverticulum]]
| |
| * [[Double aortic arch]]
| |
| * [[Elongated styloid process]]
| |
| * [[Enlarged left atrium]]
| |
| * [[Eosinophilic esophagitis]]
| |
| * [[Epiglottitis]]
| |
| * [[Esophageal achalasia]]
| |
| * [[Esophageal atresia]]
| |
| * [[Esophageal cancer]]
| |
| * [[Esophageal moniliasis]]
| |
| * [[Esophageal spasm]]
| |
| * [[Esophageal stricture ]]
| |
| * [[Esophagus|Esophageal]] [[Trauma|trauma]]
| |
| * [[Esophageal sarcoidosis]]
| |
| * [[Esophagitis ]]
| |
| * [[Esophagotracheal fistula]]
| |
| * [[Extreme spinal curvature]]
| |
| * [[Fibrosis]]
| |
| * [[Flu]]
| |
| * [[Gastric tumors]]
| |
| * [[Gastritis]]
| |
| * [[Gastroesophageal reflux]]
| |
| * [[Gaucher's disease]]<ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018671/</ref>
| |
| * [[Global hystericus]]<ref>http://www.ncbi.nlm.nih.gov/pubmed/6875362</ref>
| |
| * [[Glossitis]]
| |
| * [[Goiter]]
| |
| * [[Graft versus host reaction]]
| |
| * [[Guillain-Barre syndrome]]
| |
| * [[Gum disease]]
| |
| * [[Herpangina]]
| |
| * [[Herpes simplex virus (HSV)]]
| |
| * [[Herpes stomatitis ]]
| |
| * [[HIV/AIDS]]
| |
| * [[Huntington's chorea]]
| |
| * [[Hyperthyroidism]]
| |
| * [[Hypopharyngeal cancer ]]
| |
| * [[Hypothyroidism]]
| |
|
| |
|
| {{ColBreak}}
| | [[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]] |
| * [[Inclusion body myositis]]
| |
| * [[Intramural pseudodiverticulosis]]
| |
| * [[Laryngeal cancer]]
| |
| * [[Laryngitis]]
| |
| * [[Leiomyoma]]
| |
| * [[Lymphadenopathy]]
| |
| * [[Mediastinitis]]
| |
| * [[Mitral valve stenosis]]
| |
| * [[Mononucleosis]]
| |
| * [[Multiple Sclerosis]]
| |
| * [[Mumps]]
| |
| * [[Myasthenia Gravis]]
| |
| * [[Myoneurogastrointestinal encephalopathy syndrome]]<ref>http://ghr.nlm.nih.gov/condition/mitochondrial-neurogastrointestinal-encephalopathy-disease</ref>
| |
| * [[Neuroferritinopathy]]<ref>http://www.ncbi.nlm.nih.gov/books/NBK1141/</ref>
| |
| * [[Opitz-Frias syndrome]]<ref>http://www.ncbi.nlm.nih.gov/books/NBK1523/</ref>
| |
| * [[Oral cancer ]]
| |
|
| |
|
| * [[Oral submucous fibrosis]]
| | ==Case Studies== |
| * [[Oral ulcers]]
| | [[Odynophagia case study one|Case #1]] |
| * [[Oral candidiasis]]
| |
| * [[Palate cancer]]
| |
| * [[Palatoplegia]]
| |
| * [[Paracoccidioidomycosis]]
| |
| * [[Paraneoplastic syndrome]]
| |
| * [[Parkinson's Disease]]
| |
| * [[Peptic stenosis]]
| |
| * [[Peripheral neuropathy]]
| |
| * [[Pharyngitis]]
| |
| * [[Plummer-Vinson Syndrome]]
| |
| * [[Poliomyelitis]]
| |
| * [[Polyradiculitis]]
| |
| * [[Rabies]]
| |
| * [[Radiation esophagitis]]
| |
| * [[Reflux esophagitis]]
| |
| * [[Respiratory tract infections ]]
| |
| * [[Retropharyngeal abscess ]]
| |
| * [[Rheumatoid Arthritis]]
| |
| * [[Riedel thyroiditis]]
| |
| * [[Scarlet Fever]]
| |
| * [[Schatzki ring]]
| |
| * [[Scleroderma]]
| |
| * [[Stevens-Johnson Syndrome]]
| |
| * [[Stomatitis]]
| |
| * [[Supraglottic laryngeal cancer ]]
| |
| * [[Syringobulbia]]
| |
| * [[Systemic Lupus Erythematosus]]
| |
| * [[Systemic sclerosis]]
| |
| * [[Tetanus]]
| |
| * [[Tonsillar abscess]]
| |
| * [[Tooth infection]]
| |
| * [[Typhoid fever]]
| |
| * [[Vagal disorder]]
| |
| * [[Xerostomia]]
| |
| * [[Zenker's Diverticulum]]
| |
| | |
| {{EndMultiCol}}
| |
| | |
| ==Symptoms to Differentiate Odynophagia From==
| |
| * [[Dysphagia]] is defined as difficulty in swallowing
| |
| | |
| == Diagnosis ==
| |
| | |
| === History ===
| |
| A directed history should be performed to characterize the following:
| |
| * Onset
| |
| * Severity
| |
| * Duration
| |
| * Dysphagia with liquids versus solids
| |
| * Psychiatric history
| |
| * Prior episodes
| |
| * Substance exposure
| |
| * History of neck and head problems
| |
| | |
| === Laboratory Findings ===
| |
| | |
| ==== Electrolyte and Biomarker Studies ====
| |
| * Creatinine phosphokinase (CPK) can be used to rule out cardiac ischemia as a cause.
| |
| | |
| === Electrocardiogram ===
| |
| Can be used to assess for [[left atrial enlargement]].
| |
| | |
| === Chest X Ray ===
| |
| Can used to rule out [[lung cancer]] and other mass lesions as well as [[left atrial enlargement]].
| |
| | |
| === MRI and CT ===
| |
| * MRI of brain can be used to exclude CVA and mass lesions of the head and neck.
| |
| | |
| === Echocardiography or Ultrasound ===
| |
| Can be used to rule out an aneurysm or left atrial enlargement as a cause.
| |
| | |
| === Other Diagnostic Studies ===
| |
| * [[Esophagogastroduodenoscopy]] (OGD)
| |
| * [[Biopsy]]
| |
| * [[Barium swallow]]
| |
| * [[Electromyogram]] ([[EMG]])
| |
| * Nerve conduction tests
| |
| * Esophageal manometry
| |
| | |
| == Treatment ==
| |
| * Endoscopy (acute and chronic mechanical obstructions)
| |
| * Speech therapy (ALS and stroke patients)
| |
| | |
| == Pharmacotherapy ==
| |
| * Proton pump inhibitors or promotility agents, weight loss, avoidance of offending foods (gastroesophageal reflux disease)
| |
| * Anticholinergics (ALS, stroke, lower esophageal spasms)
| |
| * Muscarinic agents (myasthenia gravis)
| |
| * Glucocorticoids (myasthenia gravis and polymyositis)
| |
| * Antispasmodics, botulinum toxin injection (lower esophageal spasm)
| |
| | |
| == Surgery and Device Based Therapy ==
| |
| * Thoracic surgery, possible balloon dilation (chronic mechanical obstruction)
| |
| | |
| == References ==
| |
| {{Reflist|2}}
| |
|
| |
|
| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Musculoskeletal Disease]] | | [[Category:Musculoskeletal Disease]] |
| | [[Category:Symptoms]] |
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |
|
| |
|
| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |