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Nature Reviews. Gastroenterology &... Jun 2015Oesophageal dysphagia is a common symptom, which might be related to severe oesophageal diseases such as carcinomas. Therefore, an organic process must be ruled out in... (Review)
Review
Oesophageal dysphagia is a common symptom, which might be related to severe oesophageal diseases such as carcinomas. Therefore, an organic process must be ruled out in the first instance by endoscopy in all patients presenting with dysphagia symptoms. The most prevalent obstructive aetiologies are oesophageal cancer, peptic strictures and eosinophilic oesophagitis. Eosinophilic oesophagitis is one of the most common causes of dysphagia in adults and children, thus justifying the need to obtain oesophageal biopsy samples from all patients presenting with unexplained dysphagia. With the advent of standardized high-resolution manometry and specific metrics to characterize oesophageal motility, the Chicago classification has become a gold-standard algorithm for manometric diagnosis of oesophageal motor disorders. In addition, sophisticated investigations and analysis methods that combine pressure and impedance measurement are currently in development. In the future, these techniques might be able to detect subtle pressure abnormalities during bolus transport, which could further explain pathophysiology and symptoms. The degree to which novel approaches will help distinguish dysphagia caused by motor abnormalities from functional dysphagia still needs to be determined.
Topics: Algorithms; Deglutition Disorders; Endoscopy; Eosinophilic Esophagitis; Esophageal Motility Disorders; Esophageal Neoplasms; Esophagitis, Peptic; Esophagus; Humans; Manometry
PubMed: 25404278
DOI: 10.1038/nrgastro.2014.195 -
Optimizing Function and Appearance After Head and Neck Reconstruction: Measurement and Intervention.Otolaryngologic Clinics of North America Aug 2023Approximately 50% of head and neck cancer (HNC) survivors are left with dysphagia as a result of treatment sequele, and 25% of survivors experience clinically... (Review)
Review
Approximately 50% of head and neck cancer (HNC) survivors are left with dysphagia as a result of treatment sequele, and 25% of survivors experience clinically significant body image distress (BID). Both dysphagia and BID adversely affect quality of life and should be tracked using validated clinician- and patient-reported outcome measures such as the Performance Status Scale for Head and Neck Cancer, MD Anderson Dysphagia Inventory, and Inventory to Measure and Assess imaGe disturbancE-Head & Neck (IMAGE-HN). Subjective and objective evaluation measures are critical to dysphagia workup and management. Building a renewed image after head and neck cancer treatment, a brief telemedicine-based cognitive behavioral therapy, has become the first evidence-based treatment for BID among HNC survivors.
Topics: Humans; Deglutition Disorders; Quality of Life; Head and Neck Neoplasms; Survivors; Body Image
PubMed: 37246027
DOI: 10.1016/j.otc.2023.04.017 -
Gastroenterology Clinics of North... Sep 2018The barium esophagogram is a global test for patients with dysphagia that can simultaneously detect morphologic abnormalities in the pharynx and esophagus, pharyngeal... (Review)
Review
The barium esophagogram is a global test for patients with dysphagia that can simultaneously detect morphologic abnormalities in the pharynx and esophagus, pharyngeal swallowing dysfunction, esophageal dysmotility, and gastroesophageal reflux. The barium esophagram is an inexpensive, noninvasive, and widely available procedure that can serve as the initial diagnostic test for dysphagia and facilitate selection of other diagnostic studies such as endoscopy. This article addresses 10 questions about barium esophagography and dysphagia that should help gastroenterologists gain a better perspective about the utility of barium studies in this clinical setting.
Topics: Barium Sulfate; Deglutition Disorders; Diagnostic Techniques, Digestive System; Esophagus; Humans
PubMed: 30115432
DOI: 10.1016/j.gtc.2018.04.001 -
World Journal of Gastroenterology Oct 2017Dysphagia is a common symptom that is important to recognise and appropriately manage, given that causes include life threatening oesophageal neoplasia, oropharyngeal... (Review)
Review
Dysphagia is a common symptom that is important to recognise and appropriately manage, given that causes include life threatening oesophageal neoplasia, oropharyngeal dysfunction, the risk of aspiration, as well as chronic disabling gastroesophageal reflux (GORD). The predominant causes of dysphagia varies between cohorts depending on the interplay between genetic predisposition and environmental risk factors, and is changing with time. Currently in white Caucasian societies adopting a western lifestyle, obesity is common and thus associated gastroesophageal reflux disease is increasingly diagnosed. Similarly, food allergies are increasing in the west, and eosinophilic oesophagitis is increasingly found as a cause. Other regions where cigarette smoking is still prevalent, or where access to medical care and antisecretory agents such as proton pump inhibitors are less available, benign oesophageal peptic strictures, Barrett's oesophagus, adeno- as well as squamous cell carcinoma are endemic. The evaluation should consider the severity of symptoms, as well as the pre-test probability of a given condition. In young white Caucasian males who are atopic or describe heartburn, eosinophilic esophagitis and gastroesophageal reflux disease will predominate and a proton pump inhibitor could be commenced prior to further investigation. Upper gastrointestinal endoscopy remains a valid first line investigation for patients with suspected oesophageal dysphagia. Barium swallow is particularly useful for oropharyngeal dysphagia, and oesophageal manometry mandatory to diagnose motility disorders.
Topics: Deglutition Disorders; Humans
PubMed: 29097867
DOI: 10.3748/wjg.v23.i38.6942 -
Radiographics : a Review Publication of... 2015Dysphagia is a common clinical problem whose prevalence is increasing with the aging population in the United States. The term dysphagia is commonly used to describe... (Review)
Review
Dysphagia is a common clinical problem whose prevalence is increasing with the aging population in the United States. The term dysphagia is commonly used to describe subjective awareness of swallowing difficulty during the passage of a bolus from the mouth to the stomach or the perception of obstruction during swallowing. Dysphagia may be further classified as oropharyngeal or substernal, depending on the location of this sensation. It can be due to benign or malignant structural lesions, esophageal motility abnormalities, oropharyngeal dysfunction (including aspiration), neuromuscular disorders, or postsurgical changes and is also associated with gastroesophageal reflux disease. Pathologic conditions of the oral cavity, pharynx, esophagus, and proximal stomach can manifest with dysphagia. Imaging remains the preferred method for evaluating patients with dysphagia, and dysphagia is an increasingly encountered indication for radiologic evaluation. Fluoroscopic studies, including the modified barium swallow and esophagography in particular, are often used in the assessment of patients with dysphagia, and the techniques used for these studies should be tailored to the patient's needs. Fluoroscopic studies can be used to evaluate the esophagus for structural abnormalities (eg, webs, diverticula, strictures, masses) and to assess function (eg, the swallowing mechanism and esophageal motility). Knowledge of the imaging spectrum of disease entities that may cause dysphagia and thorough radiologic assessment with a tailored approach may help avoid misdiagnosis.
Topics: Contrast Media; Deglutition Disorders; Diagnosis, Differential; Diagnostic Imaging; Humans
PubMed: 25590391
DOI: 10.1148/rg.351130150 -
The Korean Journal of Gastroenterology... Feb 2021Dysphagia is difficulty in swallowing that can be caused by a number of disorders that involve either the oropharynx or the esophagus. Specific endoscopic treatment for... (Review)
Review
Dysphagia is difficulty in swallowing that can be caused by a number of disorders that involve either the oropharynx or the esophagus. Specific endoscopic treatment for dysphagia depends on its etiology, whether the dysphagia is caused by mechanical narrowing or a motor disorder. Variable endoscopic treatment strategies can be used to manage dysphagia. Patient with dysfunction of the upper esophageal sphincter may benefit from esophageal dilationor injection of botulinum toxin. Pneumatic balloon dilation, injection of botulinum toxin, peroral endoscopic myotomy can be considered as treatment options for esophageal motility disorders. Endoscopic dilation is the treatment choice of esophageal stricture, while intraluminal steroid injection and temporary stent can be considered in refractory benign esophageal stricture. Self-expandable metal stent insertion can be considered for dysphagia with malignant cause.
Topics: Deglutition Disorders; Dilatation; Endoscopy, Gastrointestinal; Humans
PubMed: 33632998
DOI: 10.4166/kjg.2021.025 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2020Introduction: Neurogenic dysphagia is a frequent disorder affecting people with neurological diseases. Many experts work together to diagnose and treat dysphagia. The...
OBJECTIVE
Introduction: Neurogenic dysphagia is a frequent disorder affecting people with neurological diseases. Many experts work together to diagnose and treat dysphagia. The aim: The article focuses on the specificity of neurogenic dysphagia, its symptoms and treatment possibilities. The speech pathologist can be included in the diagnostic process and can evaluate the intake of liquids and foods based on a variety of consistency tests. In clinical conditions, screening tests such as water swallowing test, multiple consistency tests: GUSS (Gugging Swallowing Screen), V-VST (Volume-Viscosity Swallow Test) and EAT-10 questionnaire can be used successfully. If you have limited ability to perform instrumental tests, they can help you to expand your diagnosis.
PATIENTS AND METHODS
Review and Discussion:Treatment of swallowing disorders is based on a daily modification of the patient's posture and consistency of the eaten meals. Nursing staff are involved in this adaptation activity, which plays an invaluable role in the diagnosis and treatment of patients in neurological and rehabilitation departments.
CONCLUSION
Conclusions: Despite the knowledge of the problem, difficulty swallowing is still unnoticed. The effects of this neglect are felt both for patients and from the perspective of management within treatment units For people suffering from neurological diseases, swallowing disorders should be diagnosed on a compulsory basis and their assessment should be a permanent part of the standard procedures for assessing patients with neurological deficits.
Topics: Deglutition Disorders; Humans; Nervous System Diseases; Sensitivity and Specificity; Surveys and Questionnaires
PubMed: 33099528
DOI: No ID Found -
Acta Gastro-enterologica Belgica 2022
Topics: Humans; Deglutition Disorders
PubMed: 36566376
DOI: 10.51821/85.3.10759 -
Current Rheumatology Reports Aug 2020Dysphagia is a common symptom in inflammatory myopathies. This review provides an overview on the epidemiology, clinical impact, and management of dysphagia in myositis.... (Review)
Review
PURPOSE OF REVIEW
Dysphagia is a common symptom in inflammatory myopathies. This review provides an overview on the epidemiology, clinical impact, and management of dysphagia in myositis. Relevant diagnostic tools and treatment strategies are discussed.
RECENT FINDINGS
Dysphagia can occur in any inflammatory myopathy, particularly in inclusion body myositis (IBM). It can lead to malnutrition or aspiration with subsequent pneumonia or even death. Dysphagia can be explored and monitored by patient-reported outcome scales for swallowing. New diagnostic tools such as real-time MRI and oro-pharyngo-esophageal scintigraphy have been studied for assessing dysphagia. Botulinum toxin injection can alleviate dysphagia in IBM. High-dose glucocorticosteroids are considered a first-line treatment for dysphagia in all other myositis subforms. Evaluation of dysphagia in myositis requires thorough clinical workup and appropriate instrumental procedures. Treatment options are available for dysphagia, but controlled trials and consensus on best patient care are required for this important symptom.
Topics: Deglutition Disorders; Humans; Myositis
PubMed: 32860119
DOI: 10.1007/s11926-020-00950-3 -
Current Opinion in Otolaryngology &... Dec 2023Dysphagia is a common symptom of sporadic inclusion body myositis (IBM), affecting disease trajectory and patient quality-of-life. Despite this, it is considerably... (Review)
Review
PURPOSE OF REVIEW
Dysphagia is a common symptom of sporadic inclusion body myositis (IBM), affecting disease trajectory and patient quality-of-life. Despite this, it is considerably understudied. The purpose of this review is to summarize current evidence related to the evaluation and management of dysphagia in IBM. We highlight a patient case involving a multidisciplinary management approach, and we encourage continued exploration of exercises for delaying progression and improving impairments in patients with IBM and dysphagia.
RECENT FINDINGS
Recent investigations confirm that dysphagia in IBM is a debilitating and complex symptom that warrants timely evaluation and management. Further, they highlight the lack of validation of standardized swallowing-related metrics specifically for IBM and the limited evidence supporting a consensus of management approaches. Small scale research and clinical anecdotal data support a multidisciplinary and multipronged patient-centered approach, including rehabilitative exercise protocols, for dysphagia management in IBM.
SUMMARY
A paucity exists in the literature to effectively guide clinical decision-making for patients with IBM and dysphagia. Given this, it is our belief that a careful multidisciplinary and multipronged patient-centered approach is critical for dysphagia management in IBM. Prospective, longitudinal research on the underlying mechanisms of swallowing dysfunction using advanced and validated swallowing-related outcome measures is urgently needed.
Topics: Humans; Deglutition Disorders; Myositis, Inclusion Body; Prospective Studies; Deglutition
PubMed: 37678324
DOI: 10.1097/MOO.0000000000000922