Odynophagia
|
Odynophagia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Odynophagia On the Web |
|
American Roentgen Ray Society Images of Odynophagia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Synonyms and keywords: painful swallowing, pain during swallowing
Overview
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)