-IBIS-1.5.0-
tx
digestive system
dysphagia/spastic esophagus
diagnoses

definition and etiology

definition:
Dysphagia is a subjective awareness of difficulty in swallowing resulting from impaired progression of matter from pharynx to stomach.

etiology:
Organic lesions of the pharynx, esophagus, adjacent organs, or functional derangements of the nervous system and musculature. For pre-esophageal dysphagia, seek CNS disorders which prevent emptying the pharynx.

Obstructive disorders (e.g. carcinoma, peptic stricture) usually prevent the passage of food from reduction of the lumen. Motor disorders usually involve smooth muscle of the esophagus (e.g. achalasia, scleroderma).

signs and symptoms

signs and symptoms:
• dysphagia: patient complains the "food gets stuck on the way down"
• chest pain
• back pain
• solids do not pass through (obstructive)
• solids and liquids do not pass through (motor)
• heartburn (reflux of gastric substances)
• odynophagia (pain with swallowing)

course and prognosis

Dependent on etiology; dysphagia from psychogenic causes or reflux may be easily managed with appropriate treatment, while dysphagia from esophageal carcinoma has a poor prognosis.

differential diagnosis

• carcinoma
• peptic stricture
• achalasia
• scleroderma
• globus hystericus (psychogenic "lump in throat")
• esophageal webs
• lower esophageal ring
• dysphagia lusoria


footnotes