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Dysphagia, a distressing symptom encountered in esophageal health, refers to difficulty or discomfort when swallowing. It can manifest as sensations of obstruction or the sensation of food getting stuck in the throat or chest. Dysphagia can significantly impact a person's ability to eat, drink, and maintain proper nutrition. If left unattended, this condition can lead to various complications.
Individuals experiencing dysphagia may report a range of symptoms, including:
With the esophagus being a crucial structure of the complex system that is the digestive system, issues can appear from multiple fronts:
Nerves play an important role in the coordination of swallowing. Disorders such as strokes, Parkinson's disease, ALS, and muscular dystrophy can impair that process.
These include benin pathologies such as esophageal strictures, webs and diverticula or outpouchings. Additionally, malignant pathologies such as cancer may also obstruct the esophagus. Initially primarily an issue when swallowing solid food.
Conditions such as achalasia or diffuse esophageal spasm can affect the normal movement of food along the esophagus (process called peristalsis). These typically cause issues when swallowing both liquids and solids
Direct damage to the nerves or muscles needed for swallowing impact peristalsis. This includes surgeries in the region during which key structures could have been injured.
Chronic acid reflux causes esophageal inflammation, scarring and strictures, which cause dysphagia.
The main risk factors are all the medical conditions mentioned above, as well as aging. Indeed, degenerative changes in the muscles and nerves involved in swallowing can occur with age.Smoking, obesity, history of chronic GERD and family history of esophageal problems are other risk factors
Diagnosing the etiology of dysphagia requires a comprehensive evaluation, which can include some, if not all of the following:
X-ray imaging to evaluate swallowing function and detect anatomical abnormalities.
Direct visualization of the esophagus with a scope to identify lesions, strictures, or tumors.
Measure of the esophageal pressure and motility in order to assess muscle function.
Evaluation of acid reflux in the esophagus to detect GERD – this is more for workup of GERD not dysohagia per se
Treating dysphagia depends on the underlying cause and severity of symptoms and may include:
Adjusting food texture, consistency, and portion sizes to facilitate swallowing.
Working with a speech-language pathologist to learn techniques and exercises to improve swallowing function.
Treating underlying conditions such as GERD or esophageal spasm pharmacologically to alleviate symptoms.
Dilating strictures, removing obstructions, or treating tumors through minimally invasive procedures.
Repairing anatomical abnormalities or performing fundoplication surgery for severe GERD.
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