-
La Revue de Medecine Interne Jan 2023
Topics: Humans; Deglutition Disorders; Tomography, X-Ray Computed
PubMed: 36404225
DOI: 10.1016/j.revmed.2022.11.003 -
Current Gastroenterology Reports Jul 2023While guidelines exist for the evaluation and management of esophageal dysphagia in the general population, dysphagia disproportionately affects the elderly. In this... (Review)
Review
PURPOSE OF REVIEW
While guidelines exist for the evaluation and management of esophageal dysphagia in the general population, dysphagia disproportionately affects the elderly. In this article, we reviewed the literature on evaluating esophageal dysphagia in elderly patients and proposed a diagnostic algorithm based on this evidence.
RECENT FINDINGS
In older patients, dysphagia is often well compensated for by altered eating habits and physiologic changes, underreported by patients, and missed by healthcare providers. Once identified, dysphagia should be differentiated into oropharyngeal and esophageal dysphagia to guide diagnostic workup. For esophageal dysphagia, this review proposes starting with endoscopy with biopsies, given its relative safety even in older patients and potential for interventional therapy. If endoscopy shows a structural or mechanical cause, then further cross-sectional imaging should be considered to assess for extrinsic compression, and same session endoscopic dilation should be considered for strictures. If biopsies and endoscopy are normal, then esophageal dysmotility is more likely, and high-resolution manometry and additional workup should be performed following the updated Chicago Classification. Even after diagnosis of the root cause, complications including malnutrition and aspiration pneumonia should also be assessed and monitored, as they both result from and can further contribute to dysphagia. The successful evaluation of esophageal dysphagia in elderly patients requires a thorough, standardized approach to collecting a history, selection of appropriate diagnostic workup, and assessment of risk of potential complications, including malnutrition and aspiration.
Topics: Humans; Aged; Deglutition Disorders; Esophageal Motility Disorders; Endoscopy, Gastrointestinal; Manometry; Malnutrition; Esophageal Achalasia
PubMed: 37312002
DOI: 10.1007/s11894-023-00876-7 -
Otolaryngologic Clinics of North America Aug 2024Gastroesophageal reflux (GER) and eosinophilic esophagitis (EoE) are the most common inflammatory causes of pediatric dysphagia, but several other less prevalent... (Review)
Review
Gastroesophageal reflux (GER) and eosinophilic esophagitis (EoE) are the most common inflammatory causes of pediatric dysphagia, but several other less prevalent conditions should be considered. These conditions can affect one or several aspects of the swallowing process. In some inflammatory conditions dysphagia may be an early symptom. Esophagoscopy and instrumental swallow studies are often needed to determine the underlying diagnosis and best treatment plan. In some inflammatory conditions dysphagia can portend a worse outcome and need for more aggressive treatment of the underlying condition. Consultations with speech language pathology, gastroenterology, dietetics, allergy/immunology and/or rheumatology are often needed to optimize management.
Topics: Humans; Deglutition Disorders; Child; Eosinophilic Esophagitis; Gastroesophageal Reflux; Esophagoscopy; Inflammation
PubMed: 38637195
DOI: 10.1016/j.otc.2024.03.002 -
Otolaryngologic Clinics of North America Jun 2019Dysphagia is a common complaint encountered in otolaryngology clinics. Approaching the patient with dysphagia starts with a comprehensive symptomatic analysis and... (Review)
Review
Dysphagia is a common complaint encountered in otolaryngology clinics. Approaching the patient with dysphagia starts with a comprehensive symptomatic analysis and thorough physical examination. The recent rapid revolution in office-based procedures has a great impact in the evaluation and management of dysphagia. Currently, diagnostic and therapeutic procedures can be performed safely and effectively in the office setting with the advantage of avoidance of sedation or general anesthesia.
Topics: Deglutition Disorders; Esophagoscopy; Humans; Manometry; Physicians' Offices
PubMed: 30905563
DOI: 10.1016/j.otc.2019.02.007 -
Gastroenterology Nursing : the Official...
Topics: Deglutition Disorders; Humans; Nutritional Status; Risk Factors; Sarcopenia
PubMed: 35713538
DOI: 10.1097/SGA.0000000000000669 -
Nutrients Aug 2023Most patients with stroke suffer from complications and these include dysphagia. Dysphagia can cause malnutrition, and malnutrition affects prognosis and recovery....
Most patients with stroke suffer from complications and these include dysphagia. Dysphagia can cause malnutrition, and malnutrition affects prognosis and recovery. However, there is a lack of accurate studies on the nutritional status of stroke patients with dysphagia and its associated factors in different phases of stroke. This study retrospectively investigated 620 stroke patients who underwent a videofluoroscopic swallowing study (VFSS) due to dysphagia, from March 2018 to February 2021. The study aimed to evaluate the nutritional state and associated factors of malnutrition in acute and subacute stroke patients with dysphagia. Serum albumin and percentage of current weight to ideal weight were used to determine nutritional status. Malnutrition was observed in 58.9 and 78.9% of acute and subacute stroke patients. Exact logistic regression analysis revealed that old age and high penetration-aspiration scale score were significantly associated factors for malnutrition in patients with acute stroke. Old age, stroke history, bilateral hemiplegia, high modified Rankin score, low Korean Mini-Mental State Examination, pneumonia, and high functional dysphagia score were significantly associated factors for malnutrition in patients with subacute stroke. Patients with these associated factors in each phase of stroke require active nutritional assessment and care to decrease the risk of malnutrition.
Topics: Humans; Deglutition Disorders; Retrospective Studies; Malnutrition; Nutritional Status; Stroke
PubMed: 37686771
DOI: 10.3390/nu15173739 -
Clinics in Perinatology Dec 2018Dysphagia and aspiration are commonly encountered problems in the neonatal population. It is often multifactorial in nature and management should be tailored to the... (Review)
Review
Dysphagia and aspiration are commonly encountered problems in the neonatal population. It is often multifactorial in nature and management should be tailored to the individual patient. Multiple causes should be considered, including anatomic abnormalities, neurologic/developmental delay, cardiopulmonary disease/infection, and gastroesophageal reflux disease, in addition to those cases where a definitive reason may not be identified. Management should be multidisciplinary in nature and surgical intervention may be indicated in certain populations of patients. Here, we discuss the presentation, workup, and management of the neonatal patient with dysphagia and aspiration.
Topics: Combined Modality Therapy; Deglutition Disorders; Disease Management; Female; Gastroesophageal Reflux; Humans; Infant, Newborn; Male; Oropharynx; Patient Care Team; Pneumonia, Aspiration; Prognosis; Severity of Illness Index
PubMed: 30396410
DOI: 10.1016/j.clp.2018.07.005 -
Gastroenterology Nursing : the Official... 2019
Review
Topics: Adult; Clinical Competence; Deglutition Disorders; Esophagoscopy; Humans; Middle Aged; Nursing Assessment; Physical Examination; Risk Assessment; Severity of Illness Index
PubMed: 31145260
DOI: 10.1097/SGA.0000000000000472 -
Otolaryngologic Clinics of North America Aug 2024Older adults are projected to outnumber children aged under 18 years for the first time in United States history by 2034, according to Census Bureau projections. This... (Review)
Review
Older adults are projected to outnumber children aged under 18 years for the first time in United States history by 2034, according to Census Bureau projections. This will lead to significant increase in age-related disorders. One of the most important disorders that will increase in prevalence is dysphagia, as it leads to malnutrition, dehydration, aspiration pneumonia, and death. In this article, the physiology of dysphagia in the elderly, as well as the management options is discussed.
Topics: Humans; Deglutition Disorders; Aged; United States; Aging; Prevalence; Aged, 80 and over
PubMed: 38806319
DOI: 10.1016/j.otc.2024.03.006 -
Revue Medicale Suisse Aug 2023Dysphagia is frequent and underdiagnosed, particularly in the elderly population. It can be of oropharyngeal or esophageal origin. One should not await weight loss to...
Dysphagia is frequent and underdiagnosed, particularly in the elderly population. It can be of oropharyngeal or esophageal origin. One should not await weight loss to start investigations. Management is multidisciplinary. Complementary examinations will depend on the type of dysphagia. Digestive endoscopy plays an important role for both the diagnosis and treatment of many esophageal conditions. Peroral endoscopic myotomy (POEM), for example, is a still recent technique that has allowed progress in the minimally invasive management of achalasia.
Topics: Aged; Humans; Deglutition Disorders; Interdisciplinary Studies; Physical Examination; Weight Loss
PubMed: 37650592
DOI: 10.53738/REVMED.2023.19.839.1548