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DIFFICULTY IN SWALLOWING (DYSPHAGIA)


Difficulty in Swallowing(Dysphagia)

Dysphagia is the medical term used to describe difficulty in swallowing. Dysphagia includes difficulty starting a swallow (called oropharyngeal dysphagia) and the sensation of food being stuck in the neck or chest (called esophageal dysphagia).

Signs and symptoms associated with dysphagia are:

  • Pain while swallowing (odynophagia)
  • Vomiting
  • Coughing, choking or gagging when swallowing
  • Frequent heartburn
  • Taking more time and effort to move food or liquid from your mouth to stomach.

Causes

  • Esophageal cancer:Most important and frequent cause of dysphagia which needs to be ruled out.
  • GERD: acid reflux can cause spasm or scarring and non-cancerous narrowing (peptic stricture) of the lower esophagus.
  • Achalasiacardia
  • Muscle incoordination in esophagus causing obstruction to food bolus.
  • Post corrosive stricture (narrowed esophagus)-acid burns in the food pipe causes narrowing of esophagus.
  • Eosinophilic esophagitis: allergic reactions to food can cause dysphagia.
  • Foreign bodies
  • Esophageal webs and rings

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Complications

Difficulty swallowing can lead to:
  • Malnutrition, weight loss and dehydration.
  • Aspiration pneumonia. Food or liquid can enter the airway and cause pneumonia.
  • Choking

DIAGNOSIS:

The evaluation begins with a careful history from you. Tests will then be performed on you depending on the suspected type of dysphagia.

  • Upper GI Endoscopy and biopsy of tissues suspicious of cancer.
  • Esophageal Manometry: to assess esophageal muscle incoordination.
  • Barium swallow(X-ray with a contrast material):In case a complete endoscopic examination is not possible.
  • Imaging scans: These may include a CT scan or an MRI scanto look for lesions causing external compression of esophagus.

Treatment

  • Enlarged veins in your esophagus or stomach, called varices. Your doctor may prescribe medicines to lower the pressure in the veins of your esophagus or stomach. This lowers the chance that the veins become enlarged and burst, causing internal bleeding. If you vomit blood or have black or bloody stools go to a hospital right away.
  • Swelling in your legs, ankles, or feet, called edema. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet.
  • Buildup of fluid in your abdomen, called ascites. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet. I
  • Confusion, difficulties thinking, memory loss, personality changes, or sleep disorders, called hepatic encephalopathy.

Severe Dysphagia

If dysphagia is not treatable by the above means then the following treatment can be done:

  • A special liquid diet
  • A feeding tube
  • Esophageal stenting
Dysphagia

Diagnostic Indications & Treatment


  • Symptoms
  • Causes
  • Complications
  • Treatment
  • Severe Dysphagia
  • Pain while swallowing (odynophagia)
  • Vomiting
  • Coughing, choking or gagging when swallowing
  • Frequent heartburn
  • Taking more time and effort to move food or liquid from your mouth to stomach.
  • Esophageal cancer:Most important and frequent cause of dysphagia which needs to be ruled out.
  • GERD: acid reflux can cause spasm or scarring and non-cancerous narrowing (peptic stricture) of the lower esophagus.
  • Achalasiacardia
  • Muscle incoordination in esophagus causing obstruction to food bolus.
  • Post corrosive stricture (narrowed esophagus)-acid burns in the food pipe causes narrowing of esophagus.
  • Eosinophilic esophagitis: allergic reactions to food can cause dysphagia.
  • Foreign bodies
  • Esophageal webs and rings

Difficulty swallowing can lead to:

  • Malnutrition, weight loss and dehydration.
  • Aspiration pneumonia. Food or liquid can enter the airway and cause pneumonia.
  • Choking
  • Enlarged veins in your esophagus or stomach, called varices. Your doctor may prescribe medicines to lower the pressure in the veins of your esophagus or stomach. This lowers the chance that the veins become enlarged and burst, causing internal bleeding. If you vomit blood or have black or bloody stools go to a hospital right away.
  • Swelling in your legs, ankles, or feet, called edema. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet.
  • Buildup of fluid in your abdomen, called ascites. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet. I
  • Confusion, difficulties thinking, memory loss, personality changes, or sleep disorders, called hepatic encephalopathy.

If dysphagia is not treatable by the above means then the following treatment can be done:

  • A special liquid diet
  • A feeding tube
  • Esophageal stenting

A TIPPS Procedure was done at Kolhapur which gave patient immediate relief. This kind of procedure is done for the first time ever in this region.

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Antrang was started as ‘Antrang Endoscopy Center’ at Kolhapur by Dr. Vivekanand Kulkarni – A pioneer in the field of Gastrointestinal (G.I.) Endoscopy in Maharashtra and North Karnataka. Antrang has been providing Advanced quality medical services in Digestive diseases since 35 years. Antrang Endoscopy Center is a Brand name in Gastrointestinal Endoscopy since 1985 and now it has developed into Antrang Hospital-a Comprehensive under one roof Superspeciality Hospital with more focus on Digestive diseases.

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