Dysphagia

Felix B. Chang, FAAMA, ABIHM, MD. , ABIM Reviewed 06/2022

BASICS

Impaired passage of the alimentary bolus from the mouth to stomach (1)[C]

DESCRIPTION

Oropharyngeal: difficulty transferring food bolus from oropharynx to proximal esophagus
Esophageal: difficul...

DIAGNOSIS

HISTORY

Dysphagia to both solids and liquids from the onset of deglutition likely represents an esophageal motility disorder.
Oropharyngeal dysphagia presents as difficulty initiating the swal...

TREATMENT

GENERAL MEASURES

Exclude cardiac disease. Ensure airway patency and adequate pulmonary function. Assess nutritional status. Speech therapy

MEDICATION

Modify medications taken by patient accord...

ONGOING CARE

Swallow therapy may reduce the incidence of chest infections or pneumonia after stroke (4)[A].

FOLLOW-UP RECOMMENDATIONS

Soft-pureed diet may be useful in mechanical esophageal narrowing....

REFERENCES

ASGE Standards of Practice Committee, Pasha SF, Acosta RD, et al. The role of endoscopy in the evaluation and management of dysphagia. Gastrointest Endosc. 2014 Feb;79(2):191-201.

America...

ADDITIONAL READING

Christmas C, Rogus- Pulia N. Swallowing Disorders in the Older Population. J Am Geri Soc. 2019 Dec;67(12):2643-2649
Wilkinson J, Halland M. Esophageal...

CODES

ICD10

R13.10 Dysphagia, unspecified
R13.12 Dysphagia, oropharyngeal phase
R13.14 Dysphagia, pharyngoesophageal phase
Q39.3 Congenital stenosis and stricture of esophagus
R13.19 Other dysphagia
R13.13 ...

CLINICAL PEARLS

Esopahagogastroduodenoscopy is recommended for the initial evaluation of esophageal dysphagia, with barium esophagography as an adjunct.
Palliative care goals are to minimize coughing, ...

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