Dysphagia resident survival guide: Difference between revisions

Dysphagia ; Resident Survival Guide
Overview
Causes
Diagnosis
Treatment
Do's
Don'ts

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Revision as of 16:52, 4 August 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mounika Reddy Vadiyala, M.B.B.S.[2]

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. There are no known life-threatening causes of dysphagia.

Common Causes

Depending upon the type of dysphagia, the causes can be categorized into two subsections:^[1]^[2]^[3]^[4]^[5]^[6]

Common Causes of Oropharyngeal Dysphagia

Common causes of oropharyngeal dysphagia
Neuromuscular disorders	Mechanical and obstructive causes	Medication side effects	Others
Stroke Parkinson's disease Brain stem tumors Cranial nerve palsy or Bulbar palsy Multiple sclerosis Amyotrophic lateral sclerosis Myasthenia gravis Poliomyelitis Myotonic dystrophy Oculopharyngeal muscular dystrophy Polymyositis and dermatomyositis	Zenker's diverticulum Cricopharyngeal bar Cervical osteophytes Thyromegaly Lymphadenopathy Cervical rings or cervical webs Strictures Oropharyngeal tumors Head and neck tumors Surgical and/or radiotherapeutic interventions on head and neck tumors Retropharyngeal abscess	Medications that reduce salivary flow: Anticholinergics Angiotensin-converting enzyme inhibitors Alpha blockers Angiotensin II receptor blockers Antihistamines Antiarrhythmics Antipsychotics Mexiletine Opiates Diuretics Ipratropium bromide	Amyloidosis Cushing's syndrome Thyrotoxicosis Wilson disease Sjogren's syndrome Pharyngitis Dental disease Mucositis (Oral candidiasis, Herpetic lesions, Cytomegalovirus) Chemical injury due to caustic ingestion Diphtheria Tetanus Botulism Lead poisoning Rabies

Common Causes of Esophageal Dysphagia

The common causes of esophageal dysphagia can be divided into four categories.^[7]^[8]^[9]^[10]^[11]

Structural (Mechanical) disorders				Motor disorders		Esophageal tumors	Systemic diseases	Miscellaneous
Intrinsic compression		Extrinsic Compression		Primary	Secondary	Esophageal tumors	Systemic diseases	Miscellaneous
Mucosal rings and webs Schatzki Plummer-Vinson Multiringed esophagus (eosinophilic esophagitis)	Strictures: PUD Caustic Pill-induced Radiation-induced	Vascular compression: Dysphagia lusoria (aberrant right subclavian artery) Dysphagia aortica (enlarged aorta) Cardio-megaly (enlarged left atrium)	Mediastinal masses: Lung cancer Lymphoma Lymphadenopathy Thyromegaly Tuberculosis Histoplasmosis	Achalasia Diffuse esophageal spasm Hypertensive lower esophageal sphincter Ineffective esophageal motility disorder Nutcracker esophagus	Mixed connective tissue disease Scleroderma CREST syndrome SLE Rheumatoid arthritis Diabetes Chagas disease Paraneoplastic syndrome	Adenocarcinoma Squamous cell carcinoma Metastatic (breast carcinoma or melanoma) Leiomyoma, lymphoma, or granular cell tumor	Scleroderma (multifactorial) Pemphigus Lichen planus Crohn’s disease Rheumatoid arthritis	Functional dysphagia Postsurgery (laryngeal, esophageal, or gastric cancers) Infection esophagitis (Candida, Cytomegalovirus) Esophageal diverticula Foreign bodies

Less Common Causes

Less common causes of dysphagia include:

Scleredema adultorum^[12]^[13]
Post chemotherapy and radiation therapy^[14]
Descending thoracic aorta aneurysm^[15]
Hypertrophy of cricopharyngeal muscles^[16]

To review a complete list of dysphagia causes, click here

Diagnosis

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

Patient with Dysphagia

Difficulty in initiating a swallow
associated with cough, choking
or nasal regurgitation

Sensation of food stuk in esophagus
(seconds after initiating swallow)

Oropharyngeal dysphagia

Esophageal dysphagia

A01

B01

B02

C01

C02

D01

D02

D03

D04

E01

E02

E03

E04

F01

F02

F03

F04

F05

F06

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

Do's

The content in this section is in bullet points.

Don'ts

The content in this section is in bullet points.

References

↑ Malagelada, Juan-R.; Bazzoli, Franco; Boeckxstaens, Guy; De Looze, Danny; Fried, Michael; Kahrilas, Peter; Lindberg, Greger; Malfertheiner, Peter; Salis, Graciela; Sharma, Prateek; Sifrim, Daniel; Vakil, Nimish; Le Mair, Anton (2015). "World Gastroenterology Organisation Global Guidelines". Journal of Clinical Gastroenterology. 49 (5): 370–378. doi:10.1097/MCG.0000000000000307. ISSN 0192-0790.
↑ Cook, Ian J.; Kahrilas, Peter J. (1999). "AGA technical review on management of oropharyngeal dysphagia". Gastroenterology. 116 (2): 455–478. doi:10.1016/S0016-5085(99)70144-7. ISSN 0016-5085.
↑ 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.
↑ Espitalier, F.; Fanous, A.; Aviv, J.; Bassiouny, S.; Desuter, G.; Nerurkar, N.; Postma, G.; Crevier-Buchman, L. (2018). "International consensus (ICON) on assessment of oropharyngeal dysphagia". European Annals of Otorhinolaryngology, Head and Neck Diseases. 135 (1): S17–S21. doi:10.1016/j.anorl.2017.12.009. ISSN 1879-7296.
↑ Abdel Jalil, Ala' A.; Katzka, David A.; Castell, Donald O. (2015). "Approach to the Patient with Dysphagia". The American Journal of Medicine. 128 (10): 1138.e17–1138.e23. doi:10.1016/j.amjmed.2015.04.026. ISSN 0002-9343.
↑ Liu, Louis W C; Andrews, Christopher N; Armstrong, David; Diamant, Nicholas; Jaffer, Nasir; Lazarescu, Adriana; Li, Marilyn; Martino, Rosemary; Paterson, William; Leontiadis, Grigorios I; Tse, Frances (2018). "Clinical Practice Guidelines for the Assessment of Uninvestigated Esophageal Dysphagia". Journal of the Canadian Association of Gastroenterology. 1 (1): 5–19. doi:10.1093/jcag/gwx008. ISSN 2515-2084.
↑ Xiao Y, Kahrilas PJ, Nicodème F, Lin Z, Roman S, Pandolfino JE (2014). "Lack of correlation between HRM metrics and symptoms during the manometric protocol". Am J Gastroenterol. 109 (4): 521–6. doi:10.1038/ajg.2014.13. PMC 4120962. PMID 24513804.
↑ Enestvedt BK, Williams JL, Sonnenberg A (2011). "Epidemiology and practice patterns of achalasia in a large multi-centre database". Aliment Pharmacol Ther. 33 (11): 1209–14. doi:10.1111/j.1365-2036.2011.04655.x. PMC 3857989. PMID 21480936.
↑ Howard PJ, Maher L, Pryde A, Cameron EW, Heading RC (1992). "Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh". Gut. 33 (8): 1011–5. PMC 1379432. PMID 1398223.
↑ Pandolfino JE, Gawron AJ (2015). "Achalasia: a systematic review". JAMA. 313 (18): 1841–52. doi:10.1001/jama.2015.2996. PMID 25965233.
↑ Gockel I, Lord RV, Bremner CG, Crookes PF, Hamrah P, DeMeester TR (2003). "The hypertensive lower esophageal sphincter: a motility disorder with manometric features of outflow obstruction". J Gastrointest Surg. 7 (5): 692–700. PMID 12850684.
↑ Chatterjee S, Hedman BJ, Kirby DF (2017). "An Unusual Cause of Dysphagia". J Clin Rheumatol. doi:10.1097/RHU.0000000000000666. PMID 29280826.
↑ Wright RA, Bernie H (1982). "Scleredema adultorum of Buschke with upper esophageal involvement". Am J Gastroenterol. 77 (1): 9–11. PMID 7064968.
↑ Nguyen NP, Sallah S, Karlsson U, Antoine JE (2002). "Combined chemotherapy and radiation therapy for head and neck malignancies: quality of life issues". Cancer. 94 (4): 1131–41. PMID 11920484.
↑ Conte, Blagio A. (1966). "Dysphagia Caused by an Aneurysm of the Descending Thoracic Aorta". New England Journal of Medicine. 274 (17): 956–957. doi:10.1056/NEJM196604282741710. ISSN 0028-4793.
↑ Benedict, Edward B.; Sweet, Richard H. (1955). "Dysphagia Due to Hypertrophy of the Cricopharyngeus Muscle or Hypopharyngeal Bar". New England Journal of Medicine. 253 (26): 1161–1162. doi:10.1056/NEJM195512292532607. ISSN 0028-4793.

Template:WikiDoc Sources

[MalageladaBazzoli2015-1] Malagelada, Juan-R.; Bazzoli, Franco; Boeckxstaens, Guy; De Looze, Danny; Fried, Michael; Kahrilas, Peter; Lindberg, Greger; Malfertheiner, Peter; Salis, Graciela; Sharma, Prateek; Sifrim, Daniel; Vakil, Nimish; Le Mair, Anton (2015). "World Gastroenterology Organisation Global Guidelines". Journal of Clinical Gastroenterology. 49 (5): 370–378. doi:10.1097/MCG.0000000000000307. ISSN 0192-0790.

[CookKahrilas1999-2] Cook, Ian J.; Kahrilas, Peter J. (1999). "AGA technical review on management of oropharyngeal dysphagia". Gastroenterology. 116 (2): 455–478. doi:10.1016/S0016-5085(99)70144-7. ISSN 0016-5085.

[PhilpottGarg2017-3] 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.

[EspitalierFanous2018-4] Espitalier, F.; Fanous, A.; Aviv, J.; Bassiouny, S.; Desuter, G.; Nerurkar, N.; Postma, G.; Crevier-Buchman, L. (2018). "International consensus (ICON) on assessment of oropharyngeal dysphagia". European Annals of Otorhinolaryngology, Head and Neck Diseases. 135 (1): S17–S21. doi:10.1016/j.anorl.2017.12.009. ISSN 1879-7296.

[Abdel_JalilKatzka2015-5] Abdel Jalil, Ala' A.; Katzka, David A.; Castell, Donald O. (2015). "Approach to the Patient with Dysphagia". The American Journal of Medicine. 128 (10): 1138.e17–1138.e23. doi:10.1016/j.amjmed.2015.04.026. ISSN 0002-9343.

[LiuAndrews2018-6] Liu, Louis W C; Andrews, Christopher N; Armstrong, David; Diamant, Nicholas; Jaffer, Nasir; Lazarescu, Adriana; Li, Marilyn; Martino, Rosemary; Paterson, William; Leontiadis, Grigorios I; Tse, Frances (2018). "Clinical Practice Guidelines for the Assessment of Uninvestigated Esophageal Dysphagia". Journal of the Canadian Association of Gastroenterology. 1 (1): 5–19. doi:10.1093/jcag/gwx008. ISSN 2515-2084.

[pmid24513804-7] Xiao Y, Kahrilas PJ, Nicodème F, Lin Z, Roman S, Pandolfino JE (2014). "Lack of correlation between HRM metrics and symptoms during the manometric protocol". Am J Gastroenterol. 109 (4): 521–6. doi:10.1038/ajg.2014.13. PMC 4120962. PMID 24513804.

[pmid21480936-8] Enestvedt BK, Williams JL, Sonnenberg A (2011). "Epidemiology and practice patterns of achalasia in a large multi-centre database". Aliment Pharmacol Ther. 33 (11): 1209–14. doi:10.1111/j.1365-2036.2011.04655.x. PMC 3857989. PMID 21480936.

[pmid1398223-9] Howard PJ, Maher L, Pryde A, Cameron EW, Heading RC (1992). "Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh". Gut. 33 (8): 1011–5. PMC 1379432. PMID 1398223.

[pmid25965233-10] Pandolfino JE, Gawron AJ (2015). "Achalasia: a systematic review". JAMA. 313 (18): 1841–52. doi:10.1001/jama.2015.2996. PMID 25965233.

[pmid12850684-11] Gockel I, Lord RV, Bremner CG, Crookes PF, Hamrah P, DeMeester TR (2003). "The hypertensive lower esophageal sphincter: a motility disorder with manometric features of outflow obstruction". J Gastrointest Surg. 7 (5): 692–700. PMID 12850684.

[pmid29280826-12] Chatterjee S, Hedman BJ, Kirby DF (2017). "An Unusual Cause of Dysphagia". J Clin Rheumatol. doi:10.1097/RHU.0000000000000666. PMID 29280826.

[pmid7064968-13] Wright RA, Bernie H (1982). "Scleredema adultorum of Buschke with upper esophageal involvement". Am J Gastroenterol. 77 (1): 9–11. PMID 7064968.

[pmid11920484-14] Nguyen NP, Sallah S, Karlsson U, Antoine JE (2002). "Combined chemotherapy and radiation therapy for head and neck malignancies: quality of life issues". Cancer. 94 (4): 1131–41. PMID 11920484.

[Conte1966-15] Conte, Blagio A. (1966). "Dysphagia Caused by an Aneurysm of the Descending Thoracic Aorta". New England Journal of Medicine. 274 (17): 956–957. doi:10.1056/NEJM196604282741710. ISSN 0028-4793.

[BenedictSweet1955-16] Benedict, Edward B.; Sweet, Richard H. (1955). "Dysphagia Due to Hypertrophy of the Cricopharyngeus Muscle or Hypopharyngeal Bar". New England Journal of Medicine. 253 (26): 1161–1162. doi:10.1056/NEJM195512292532607. ISSN 0028-4793.

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@@ Line 180: / Line 180: @@
 {{familytree | | | |!| | | | | | | | | |!| }}
 {{familytree | | | C01 | | | | | | | | C02 | |C01=Oropharyngeal dysphagia|C02=Esophageal dysphagia}}
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+{{familytree | | | | | | | | | | | | B01 | | | | | | | | | | | | | | | | | | B02 | | | | | | | | | | | |B01=B01|B02=B02}}
+{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | }}
+{{familytree | | | | | | | | | | | | C01 | | | | | | | | | | | | | | | | | | C02 | | | | | | | | | | | |C01=C01|C02=C02}}
+{{familytree | | | | | | | | |,|-|-|-|^|-|-|-|.| | | | | | | | | | | |,|-|-|-|^|-|-|-|.| | | | | | | | | }}
+{{familytree | | | | | | | | D01 | | | | | | D02 | | | | | | | | | | D03 | | | | | | D04 | | | | | | | | D01=D01|D02=D02|D03=D03|D04=D04}}
+{{familytree | | | | | | | | |!| | | | |,|-|-|^|-|-|.| | | | | | | | |!| | | | |,|-|-|^|-|-|.| | | | | | | | | }}
+{{familytree | | | | | | | | |!| | | | E01 | | | | E02 | | | | | | | |!| | | | E03 | | | | E04 | | | | | | | | |E01=E01|E02=E02|E03=E03|E04=E04}}
+{{familytree | | | | | | | | |!| | | | |!| | | | | |!| | | | | | | | |!| | | | |!| | | | | |!| | | | | | | }}
+{{familytree | | | | | | | | F01 | | | F02 | | | | F03 | | | | | | | F04 | | | F05 | | | | F06 | | | | | | | | |F01=F01|F02=F02|F03=F03|F04=F04|F05=F05|F06=F06}}
 {{familytree/end}}