Dysphagia barium swallow: Difference between revisions
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===Oropharyngeal Dysphagia=== | ===Oropharyngeal Dysphagia=== | ||
A patient needing further investigation in '''oropharyngeal dysphagia''' will most likely receive a Modified Barium Swallow (MBS). Different consistencies of liquid and food mixed with [[barium]] sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy. A patient's swallowing then can be evaluated and described. Some clinicians might choose to describe the swallow in detail, making mention of any delays or deviations from the norm. Others might choose to use a rating scale such as the Penetration Aspiration Scale. The scale was developed to describe the disordered physiology of a person's swallow using the numbers 1-8.<ref>Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. "Dysphagia, 11," 93-98.</ref> Other scales also exist for this purpose. | A patient needing further investigation in '''oropharyngeal dysphagia''' will most likely receive a Modified Barium Swallow (MBS). Different consistencies of liquid and food mixed with [[barium]] sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy. A patient's swallowing then can be evaluated and described. Some clinicians might choose to describe the swallow in detail, making mention of any delays or deviations from the norm. Others might choose to use a rating scale such as the Penetration Aspiration Scale. The scale was developed to describe the disordered physiology of a person's swallow using the numbers 1-8.<ref>Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. "Dysphagia, 11," 93-98.</ref> Other scales also exist for this purpose. | ||
===Esophageal Dysphagia=== | |||
Once esophageal dysphagia has been implicated, the next step is either a ''[[barium swallow]]'' or an ''[[EGD|upper endoscopy]]''. If there is any suspicion of a proximal lesion such as: | |||
* History of surgery for laryngeal or esophageal cancer | |||
* History of radiation or irritating injury | |||
* [[Achalasia]] | |||
* [[Zenker's diverticulum]], a barium swallow should be performed first instead of endoscopy to prevent any perforation. If [[achalasia]] suspected on barium swallow, [[manometry]] is performed next to confirm. If a stricture is suspected, endoscopy is performed. Any other lesions found are treated as such. | |||
==References== | ==References== | ||
Revision as of 16:02, 26 August 2012
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Risk calculators and risk factors for Dysphagia barium swallow |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Barium Swallow
Oropharyngeal Dysphagia
A patient needing further investigation in oropharyngeal dysphagia will most likely receive a Modified Barium Swallow (MBS). Different consistencies of liquid and food mixed with barium sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy. A patient's swallowing then can be evaluated and described. Some clinicians might choose to describe the swallow in detail, making mention of any delays or deviations from the norm. Others might choose to use a rating scale such as the Penetration Aspiration Scale. The scale was developed to describe the disordered physiology of a person's swallow using the numbers 1-8.[1] Other scales also exist for this purpose.
Esophageal Dysphagia
Once esophageal dysphagia has been implicated, the next step is either a barium swallow or an upper endoscopy. If there is any suspicion of a proximal lesion such as:
- History of surgery for laryngeal or esophageal cancer
- History of radiation or irritating injury
- Achalasia
- Zenker's diverticulum, a barium swallow should be performed first instead of endoscopy to prevent any perforation. If achalasia suspected on barium swallow, manometry is performed next to confirm. If a stricture is suspected, endoscopy is performed. Any other lesions found are treated as such.
References
- ↑ Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. "Dysphagia, 11," 93-98.