Dysphagia endoscopy: Difference between revisions

	Dysphagia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Dysphagia from other Conditions
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Barium Swallow
Endoscopy
CT
MRI
Echocardiography and Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Dysphagia endoscopy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Dysphagia endoscopy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Dysphagia endoscopy
CDC on Dysphagia endoscopy
Dysphagia endoscopy in the news
Blogs on Dysphagia endoscopy
Directions to Hospitals Treating Dysphagia
Risk calculators and risk factors for Dysphagia endoscopy

← Older edit Newer edit →

VisualWikitext

Revision as of 17:30, 23 February 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Feham Tariq, MD [3]

Overview

FEES and VFSS may be helpful in the diagnosis of dysphagia.

Endoscopy

Flexible fiberoptic endoscopic examination of swallowing (FEES)

Indications

FEES is indicated in

In critically ill patients
Patients who cannot be transferred to the fluoroscopy room,
Patients who require prompt evaluation.

Procedure

A scope is passed through the nasal cavity to evaluate nasopharynx, laryngopharynx, and hypopharynx.
If no structural abnormalities are seen, pharyngeal response is tested before and after swallowing.
A normal endoscopy is followed by manometry.

Interpretation of FEES

The endoscopy findings for dysphagia are as follows:^[1]^[2]

Middle and lower biopsies of the esophagus should be taken with the intention of excluding eosinophilic esophagitis.
Majority will be normal or demonstrates only mild erosive disease.
Structural abnormalities
- Strictures
- GERD
- Webs/Rings

Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach. This is a complication of chronic gastroesophageal reflux disease, and can be a cause of dysphagia.

References

↑ Philpott, Hamish; Garg, Mayur; Tomic, Dunya; Balasubramanian, Smrithya; Sweis, Rami (2017). "Dysphagia: Thinking outside the box". World Journal of Gastroenterology. 23 (38): 6942–6951. doi:10.3748/wjg.v23.i38.6942. ISSN 1007-9327.
↑ Scheurer U (1991). "[Dysphagia]". Ther Umsch. 48 (3): 150–61. PMID 2042117.

Template:WH Template:WS

[PhilpottGarg2017-1] Philpott, Hamish; Garg, Mayur; Tomic, Dunya; Balasubramanian, Smrithya; Sweis, Rami (2017). "Dysphagia: Thinking outside the box". World Journal of Gastroenterology. 23 (38): 6942–6951. doi:10.3748/wjg.v23.i38.6942. ISSN 1007-9327.

[pmid2042117-2] Scheurer U (1991). "[Dysphagia]". Ther Umsch. 48 (3): 150–61. PMID 2042117.

[1]

[2]

@@ Line 5: / Line 5: @@
 ==Overview==
+FEES and VFSS may be helpful in the diagnosis of dysphagia.
 ==Endoscopy==
-The endoscopy findings for dysphagia are as follows:<ref name="PhilpottGarg2017">{{cite journal|last1=Philpott|first1=Hamish|last2=Garg|first2=Mayur|last3=Tomic|first3=Dunya|last4=Balasubramanian|first4=Smrithya|last5=Sweis|first5=Rami|title=Dysphagia: Thinking outside the box|journal=World Journal of Gastroenterology|volume=23|issue=38|year=2017|pages=6942–6951|issn=1007-9327|doi=10.3748/wjg.v23.i38.6942}}</ref><ref name="pmid2042117">{{cite journal| author=Scheurer U| title=[Dysphagia]. | journal=Ther Umsch | year= 1991 | volume= 48 | issue= 3 | pages= 150-61 | pmid=2042117 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2042117  }} </ref>
+Flexible fiberoptic endoscopic examination of swallowing (FEES)
-*Middle and lower biopsies of the esophagus should be taken with the intention of excluding eosinophilic esophagitis
-*Majority will be normal or demonstrates only mild erosive disease
-===Oropharyngeal Dysphagia===
+=== Indications ===
-* A patient can be assessed using [[videoendoscopy]], also known as [[flexible fiberoptic endoscopic examination of swallowing]] ([[FEES]]).
+FEES is indicated in
-** The scope is placed into the nose until the clinician can view the [[pharynx]] and then he or she examines the pharynx and [[larynx]] before and after swallowing.
+* In critically ill patients
-** During the actual swallow, the camera is blocked from viewing the anatomical structures.
+* Patients who cannot be transferred to the fluoroscopy room,
+* Patients who require prompt evaluation.
-* A rigid scope can be placed into the oral cavity to view the structures of the pharynx and larynx.
+=== Procedure ===
+* A scope is passed through the nasal cavity to evaluate nasopharynx, laryngopharynx, and hypopharynx.
+* If no structural abnormalities are seen, pharyngeal response is tested before and after swallowing.
+*A normal endoscopy is followed by manometry.
-===Esophageal Dysphagia===
+=== Interpretation of FEES ===
-*If there is no suspicion of history of surgery for laryngeal or esophageal cancer, history of radiation or irritating injury, [[achalasia]], [[zenker's diverticulum]], endoscopy can be performed first.
+The endoscopy findings for dysphagia are as follows:<ref name="PhilpottGarg2017">{{cite journal|last1=Philpott|first1=Hamish|last2=Garg|first2=Mayur|last3=Tomic|first3=Dunya|last4=Balasubramanian|first4=Smrithya|last5=Sweis|first5=Rami|title=Dysphagia: Thinking outside the box|journal=World Journal of Gastroenterology|volume=23|issue=38|year=2017|pages=6942–6951|issn=1007-9327|doi=10.3748/wjg.v23.i38.6942}}</ref><ref name="pmid2042117">{{cite journal| author=Scheurer U| title=[Dysphagia]. | journal=Ther Umsch | year= 1991 | volume= 48 | issue= 3 | pages= 150-61 | pmid=2042117 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2042117  }} </ref>
-*Any structural or mucosal abnormality is treated.
+*Middle and lower biopsies of the esophagus should be taken with the intention of excluding eosinophilic esophagitis.
-*A normal endoscopy should be followed by manometry; and if manometry is also normal, the diagnosis of functional dysphagia is made.
+*Majority will be normal or demonstrates only mild erosive disease.
+*Structural abnormalities
+**Strictures
+**GERD
+**Webs/Rings
 [[Image:Peptic stricture.png|center|thumb|200px|[[Gastroscopy|Endoscopic]] image of peptic stricture, or narrowing of the [[esophagus]] near the junction with the [[stomach]]. This is a complication of chronic gastroesophageal reflux disease, and can be a cause of dysphagia.]]