Dysphagia causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
Common Causes
- A stroke can trigger a rapid onset of dysphagia with a high occurrence of aspiration. The function of normal swallowing may or may not return completely following an acute phase lasting approximately 6 weeks. [1]
- Parkinson's disease can cause "multiple prepharyngeal, pharyngeal, and esophageal abnormalities". The severity of the disease most often correlates with the severity of the swallowing disorder.[1]
- Neurologic disorders such as stroke, Parkinson's disease, amyotrophic lateral sclerosis, Bell's palsy, or myasthenia gravis can cause weakness of facial and lip muscles that are involved in coordinated mastication as well as weakness of other important muscles of mastication and swallowing.
- Oculopharyngeal muscular dystrophy is a genetic disease with palpebral ptosis, oropharyngeal dysphagia, and proximal limb weakness.
- Decrease in salivary flow, which can lead to dry mouth or xerostomia, can be due to Sjogren's syndrome, anticholinergics, antihistamines, or certain antihypertensives and can lead to incomplete processing of food bolus.
- Xerostomia can reduce the volume and increase the viscosity of oral secretions making bolus formation difficult as well as reducing the ability to initate and swallow the bolus[1]
- Dental problems can lead to inadequate chewing.
- Abnormality in oral mucosa such as from mucositis, aphthous ulcers, or herpetic lesions can interfere with bolus processing.
- Mechanical obstruction in the oropharynx may be due to malignancies, cervical rings or webs, or cervical osteophytes.
- Increased upper esophageal sphincter tone can be due to Parkinson's disease which leads to incomplete opening of the UES. This may lead to formation of a Zenker's diverticulum.
- Pharyngeal pouches typically cause difficulty in swallowing after the first mouthful of food, with regurgitation of the pouch contents. These pouches are also marked by malodorous breath due to decomposing foods residing in the pouches. (See Zenker's diverticulum)
- Dysphagia is often a side effect of surgical procedures like anterior cervical spine surgery, carotid endarterectomy, head and neck resection, oral surgeries like removal of the tongue, and parietal laryngectomies [1]
- Radiotherapy, used to treat head and neck cancer, can cause tissue fibrosis in the irradiated areas. Fibrosis of tongue and larynx lead to reduced tongue base retraction and laryngeal elevation during swallowing[1]
- Infection may cause pharyngitis which can prevent swallowing due to pain.
- Medications can cause central nervous system effects that can result in an oropharyngeal dysphagia. Examples: sedatives, hypnotic agents, anticonvulsants, antihistamines, neuroleptics, barbiturates, and antiseizure medication. Medications can also cause peripheral nervous system effects resulting in an oropharyngeal dysphagia. Examples: corticosteroids, L-tryptophan, and anticholinergics[1]
Causes in Alphabetical Order[2] [3]
- Abscess
- Achalasia
- Aerophagia
- Agranulocytosis
- Alcoholism
- Allergic swelling
- Amyloidosis
- Amyotrophic Lateral Sclerosis (ALS)
- Angina tonsillaris
- Anxiety disorders
- Aortic aneurysm
- Aspiration of foreign body
- Barret's Syndrome
- Behcet's Syndrome
- Botulism
- Brainstem stroke
- Bronchial carcinoma
- Bulbar palsy
- Candidiasis
- Cascade stomach
- Central hypoglossal nerve paralysis
- Central vagal nucleus lesion
- Cerebrovascular accident (CVA)
- Chagas Disease
- Chemical burns
- CREST syndrome: (calcinosis, raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias)
- Cytomegalovirus (CMV)
- Dermatomyositis
- Diabetic neuropathy
- Diphtheria
- Diverticulum
- Enlarged left atrium
- Esophageal cancer
- Esophageal Crohn's disease
- Esophageal diverticulum
- Esophageal moniliasis
- Esophageal sarcoidosis
- Esophageal spasm
- Esophageal trauma
- Esophagotracheal fistula
- Extreme spinal curvature
- Fibrosis
- Food bolus
- Gastric cancer
- Gastritis
- Gastroparesis
- Global hystericus
- Globus syndrome
- Goiter
- Graft-versus-host disease
- Guillain-Barre Syndrome
- Herpangina
- Herpes simplex virus (HSV)
- Hiatal hernia
- Huntington's chorea
- Hyperthyroidism
- Hypokalemia
- Hypothyroidism
- Idiopathic human immunodeficiency virusHIV ulcers
- Impaired sensitivity in the larynx
- Intramural pseudodiverticulosis
- Laryngeal cancer
- Lateral funiculus angina
- Leiomyoma
- Ludwig's angina
- Lymph granulomatosis
- Lymphadenopathy
- Medication-induced esophagitis
- Mononucleosis
- Multiple Sclerosis
- Mumps
- Myasthenia Gravis
- Neoplastic (external compression)
- Nutcracker esophagus
- Oral candidiasis
- Osteophytes
- Palatoplegia after damage to the vagal nerve or the accessory nerve
- Paraneoplastic syndrome
- Parkinson's Disease
- Pericarditis
- Peripheral neuropathy
- Peripheral tongue paralysis with lesions of the hypoglossal nerve
- Pharyngitis
- Pleuritis
- Plummer-Vinson Syndrome
- Poliomyelitis
- Polyradiculitis
- Pseudoachalasia
- Pseudobulbar paralysis
- Pyloric stenosis
- Rabies
- Radiation esophagitis
- Reflux esophagitis
- Rheumatoid Arthritis
- Scarlet Fever
- Schatzki ring
- Scleroderma
- Stevens-Johnson Syndrome
- Stomatitis
- Syringobulbia
- Systemic Lupus Erythematosus
- Tetanus
- Tonsillar abscess
- Typhoid fever angina
- Vascular abnormality
- Vincent's angina
- Zenker's Diverticulum
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Murray, J. (1999). Manual of Dysphagia Assessment in Adults. San Diego: Singular Publishing.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X