Dysphagia pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
=== Normal physiology of the food motility through the esophagus === | |||
* The [[esophagus]] is a part of the [[gastrointestinal tract]] which is responsible of moving [[Food|the food]] from the [[mouth]] to the [[rectum]].<ref name="pmid1606845">{{cite journal| author=Stein HJ, DeMeester TR| title=Outpatient physiologic testing and surgical management of foregut motility disorders. | journal=Curr Probl Surg | year= 1992 | volume= 29 | issue= 7 | pages= 413-555 | pmid=1606845 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1606845 }}</ref> | |||
* The esophagus has anti-reflux barrier which prevents the return of the [[acidic]] contentof the [[stomach]] back to the [[esophagus]]. The anti-reflux barrier consists of the [[lower esophageal sphincter]] (LES) and the related part of the [[diaphragm]]. | |||
* The [[lower esophageal sphincter]] is contracting [[smooth muscle]] at the end of the [[esophagus]] responsible for the food passage to the [[stomach]]. LES has high pressure tone which helps keeping it a strong barrier between the [[esophagus]] and the [[stomach]]. | |||
[[Image:GERD.png|350px|thumb|center|Source by:BruceBlaus - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=44923646|]] | |||
Schematically the pthophysiology can be presented as a tree diagram: | Schematically the pthophysiology can be presented as a tree diagram: | ||
{{familytree/start}} | {{familytree/start}} | ||
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Pathophysiology
Normal physiology of the food motility through the esophagus
- The esophagus is a part of the gastrointestinal tract which is responsible of moving the food from the mouth to the rectum.[1]
- The esophagus has anti-reflux barrier which prevents the return of the acidic contentof the stomach back to the esophagus. The anti-reflux barrier consists of the lower esophageal sphincter (LES) and the related part of the diaphragm.
- The lower esophageal sphincter is contracting smooth muscle at the end of the esophagus responsible for the food passage to the stomach. LES has high pressure tone which helps keeping it a strong barrier between the esophagus and the stomach.
Schematically the pthophysiology can be presented as a tree diagram:
| Esophageal dysphagia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Solids & liquids (Neuromuscular) | Solids only (Mechanical obstruction) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Progressive | Intermittent | Intermittent | Progressive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Scleroderma | Achalasia | Diffuse esophageal spasm | Lower esophageal ring | Cancer | Peptic stricture | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Stein HJ, DeMeester TR (1992). "Outpatient physiologic testing and surgical management of foregut motility disorders". Curr Probl Surg. 29 (7): 413–555. PMID 1606845.