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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

1
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. 
2
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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