Esophageal Dysphagia

Lawal, Adeyemi; Shaker, Reza

doi:10.1016/j.pmr.2008.07.003

Cited by 16 publications

(15 citation statements)

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“…Dysphagia is the sensation of food being hindered during the passage from the mouth through the esophagus into the stomach, and is considered a serious red flag or alarm symptom . There are many causes of dysphagia classified into oropharyngeal or esophageal etiologies . Oropharyngeal dysphagia may arise from neurologic diseases including stroke, Parkinson's disease, or amyotrophic lateral sclerosis, or a Zenker's diverticula .…”

Section: Introductionmentioning

confidence: 99%

“…2,3 There are many causes of dysphagia classified into oropharyngeal or esophageal etiologies. [4][5][6] Oropharyngeal dysphagia may arise from neurologic diseases including stroke, Parkinson's disease, or amyotrophic lateral sclerosis, or a Zenker's diverticula. 4 Causes of esophageal dysphagia 5 include esophageal dysmotility (e.g., achalasia, diffuse esophageal spasm, nutcracker esophagus, or scleroderma), inflammation (e.g., eosinophilic esophagitis, radiation esophagitis), and structural abnormalities (e.g., malignancy, peptic strictures, esophageal rings, or external compression).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors for dysphagia: a USA community study

Cho

Choung

Saito

et al. 2014

Neurogastroenterology Motil

118

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Background Dysphagia is considered an alarm symptom but detailed population-based data on dysphagia are lacking. We aimed to estimate in a representative US Caucasian population the prevalence of dysphagia and potential risk factors. Methods A modified version of the previously validated Bowel Disease Questionnaire was mailed to a population based cohort (n=7640) of Olmsted County, MN. Dysphagia was measured by one validated question “In the last year, how often have you had difficulty swallowing (a feeling that food sticks in your throat or chest)?” The medical records were reviewed for organic causes of dysphagia. The associations of reported frequency of dysphagia with potential risk factors were assessed using logistic regression models. Results The sex-specific, age-adjusted (US White 2000) prevalence for dysphagia experienced at least weekly was 3.0 % (95% CI: 2.2, 3.7) in females and 3.0 % (95% CI: 2.0, 4.0) in males. Those with frequent heartburn [OR=5.9 (4.0, 8.6)] and acid regurgitation [OR=10.6 (6.8, 16.6)] were significantly more likely to report frequent dysphagia. PPI use was significantly associated with frequent (3.1, 95% CI 2.2, 4.4) and infrequent dysphagia (1.5, 955 CI 1.3, 1.8). GERD was the most common diagnosis in those reporting dysphagia on the medical record; other organic explanations were rare and only found in the frequent dysphagia group. Conclusions Frequent dysphagia is not rare in the community (3%), occurs in both women and men across all adult age groups, and is most likely to indicate underlying GERD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors for dysphagia: a USA community study

Cho

Choung

Saito

et al. 2014

Neurogastroenterology Motil

118

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“…Patients with Chagas' disease have difficulty in swallowing a large volume of water, with a significant reduction in the volume they are able to swallow compared with healthy volunteers 21 . We did not find differences between patients with Chagas' disease and patients with idiophatic achalasia showing that, despite the differences observed in the etiopathogenesis of the diseases 1,17,20 . The two causes of achalasia, primary and secondary, involve similar changes in esophageal motility.…”

Section: Discussionmentioning

confidence: 54%

“…A loss of myenteric plexus neurons occurs in the proximal esophagus of Chagas' disease patients, but the percentage of loss is lower than in the distal esophagus 14 . The involvement of the central nervous system in the chronic phase of Chagas' disease does not cause major neurological deficits or dysfunction, 19 whereas degenerative changes in the vagus nerve including the dorsal motor nucleus have been reported in idiopathic achalasia 20 . The possible absence of involvement of the central control of swallowing in Chagas' disease may explain the differences in PET and amplitude between wet and dry swallows, with at least partial adaptation to the bolus, a fact that was not observed in idiopathic achalasia patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of bolus volume on proximal esophageal contractions of patients with Chagas' disease and patients with idiopathic achalasia

Dantas¹,

Alves²,

Nascimento³

2010

Diseases of the Esophagus

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Chagas' disease and idiopathic achalasia patients have similar impairment of distal esophageal motility. In Chagas' disease, the contractions occurring in the distal esophageal body are similar after wet or dry swallows. Our aim in this investigation was to evaluate the effect of wet swallows and dry swallows on proximal esophageal contractions of patients with Chagas' disease and with idiopathic achalasia. We studied 49 patients with Chagas' disease, 25 patients with idiopathic achalasia, and 33 normal volunteers. We recorded by the manometric method with continuous water perfusion the pharyngeal contractions 1 cm above the upper esophageal sphincter and the proximal esophageal contractions 5 cm from the pharyngeal recording point. Each subject performed in duplicate swallows of 3-mL and 6-mL boluses of water and dry swallows. We measured the time between the onset of pharyngeal contractions and the onset of proximal esophageal contractions (pharyngeal-esophageal time [PET]), and the amplitude, duration, and area under the curve (AUC) of proximal esophageal contractions. Patients with Chagas' disease and with achalasia had longer PET, lower esophageal proximal contraction amplitude, and lower AUC than controls (P≤ 0.02). In Chagas' disease, wet swallows caused shorter PET, higher amplitude, and higher AUC than dry swallows (P≤ 0.03).There was no difference between swallows of 3- or 6-mL boluses. There was no difference between patients with Chagas' disease and with idiopathic achalasia. We conclude that patients with Chagas' disease and with idiopathic achalasia have a delay in the proximal esophageal response and lower amplitude of the proximal esophageal contractions.

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“…Hastaların daha yaşlı olması, progresif ve hızlı ilerleyen disfaji bulunması ve kilo kaybı (benign striktürlü hastalar yüksek kalorili yumuşak gıdalarla beslenerek kilolarını koruyabilirler) bulunması özofagus kanseri lehinedir (7).…”

Section: Introductionunclassified

Symptoms and Signs in Esophageal Cancer

Çelik¹

2013

Toraks Cer Bult

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ÖzetÖzofagus kanseri tüm dünyada en sık görülen kanserler içerisinde 8. sırada yer almaktadır. Özofagus kanserli hastalar tipik olarak 60-70'li yaşlarındadırlar. Hastaların çoğunda sigara ve alkol öyküsü vardır. Klinik tablo, tümörün direkt etkisi, hastalığın rejyonel ve uzak metastaz bulguları ve paraneoplastik sendromlar ile şekillenir. Genellikle en sık başvuru şikayeti, hastaların %80-90'ında bulunan disfajidir. Özofagus kanseri kronik ve progresif disfajiye neden olur. İkinci en sık izlenen şikayet, özofagus kanserli hastaların yarısından fazlasında izlenen kilo kaybıdır. Göğüs ağrısı sıklıkla tarif edilir. Regürjitasyon ve kusma, rekürren larengeal sinir tutulumuna bağlı ses kısıklığı, trakeobronşial ağacın tutulumuna bağlı öksürük, özofagotrakeal fistül ile birlikte veya birlikte olmadan aspirasyon pnömonisi, hematemez ve melena, frenik sinir paralizisine bağlı diafragma evantrasyonu, Vena Cava Superior sendromu, malign plevral efüzyonlar, servikal veya supraklaviküler lenfadenopatiler başvuru sırasında rastlanabilecek diğer semptomlar ve belirtilerdir. Üst gastrointestinal sistem (GIS) kanserlerinde gözlenen disfaji, kilo kaybı, GIS kanaması, anemi ve kusma şikayet ve bulgularını "alarm semptomları" olarak bildirilmiş ve bu semptomların bulunduğu hastalarda malignite saptanması ihtimalinin 5-6 kat daha fazla olduğunu belirlenmiştir. Özofagus kanserli hastalarda tüm belirtiler içinde, hayat kalitesi üzerindeki direkt etkisi göz önünde bulundurulduğunda en acı veren ve kuvvetten düşüren belirti disfajidir. Buna rağmen yutma güçlüğü şika-yeti olan özellikle genç hastaların doktora başvurma oranları düşüktür. Sonuç olarak; özofagus kanseri erken evrede sinsi seyreden ve genellikle hastalığın ilerlemesi ile belirti veren bir hastalık olması, yaygın kullanılabilecek tarama yöntemlerinin bulunmaması ve toplum tarafından hakkında az bilgiye sahip olunan bir hastalık olması nedeniyle tanı ve tedavisi geciken bir hastalıktır. Anahtar kelimeler: Özofagus kanseri, semptomlar, bulgular AbstractCancer of the esophagus is the 8 th most common malignancy diagnosed worldwide. Patients with esophageal cancer are typically in their 6 th or 7 th decade. Majority of the patients have a history of smoking and alcohol usage. Clinical presentation consists of the symptoms due to the local impact of the tumor, regional or distant metastases and paraneoplastic syndrome. Dysphagia is the most common symptom, which is seen in 80% to 90% of the patients. Esophageal cancer causes chronic and progressive dysphagia. Weight loss is the second most common complaint observed in more than 50% of the patients. Patients frequently describe chest pain. Regurgitation and vomiting, hoarseness due to invasion of the recurrent laryngeal nerve, cough caused by the invasion of the tracheobronchial tree, aspiration pneumonia with or without esophagotracheal fistula, hematemesis and melena, diaphragmatic evantration due to invasion of the phrenic nerve, Vena Cava Superior Syndrome, malignant pleural effusions and lymphadenopathies of the cervical and...

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Esophageal Dysphagia

Cited by 16 publications

References 50 publications

Prevalence and risk factors for dysphagia: a USA community study

Prevalence and risk factors for dysphagia: a USA community study

Effect of bolus volume on proximal esophageal contractions of patients with Chagas' disease and patients with idiopathic achalasia

Symptoms and Signs in Esophageal Cancer

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