Swallowing Difficulties
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Swallowing Difficulties
Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of pharyngeal sensation or various other inadequacies of the swallowing mechanism. Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing, and globus, which is the sensation of a lump in the throat. A person can have dysphagia without odynophagia (dysfunction without pain), odynophagia without dysphagia (pain without dysfunction) or both together. A psychogenic dysphagia is known as phagophobia. Classification Dysphagia is classified into the following major types: # Oropharyngeal dysphagia # Esophageal and obstructive dysphagia # Neuromuscular symptom complexes # Functional dysphagia is defined in some patients as having no organic cause for ...
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Gastroenterology
Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the ''GI tract,'' which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which includes the pancreas, gallbladder, and liver. The digestive system functions to move material through the GI tract via peristalsis, break down that material via digestion, absorb nutrients for use throughout the body, and remove waste from the body via defecation. Physicians who specialize in the medical specialty of gastroenterology are called gastroenterologists or sometimes ''GI doctors''. Some of the most common conditions managed by gastroenterologists include gastroesophageal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, irritable bowel dise ...
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New York University School Of Medicine
NYU Grossman School of Medicine is a medical school of New York University, a private research university in New York City. It was founded in 1841 and is one of two medical schools of the university, with the other being the Long Island School of Medicine. NYU Grossman School of Medicine is part of NYU Langone Health, named after Kenneth Langone, the investment banker and financial backer of The Home Depot. In 2022, U.S''. News & World Report'' ranked NYU Grossman School of Medicine as No. 2 “Best Graduate Schools". History New York University College of Medicine was established in 1841. The medical school merged with Bellevue Hospital Medical College in 1898 to form the University and Bellevue Hospital Medical College. The name NYU Grossman School of Medicine was adopted in 2019. NYU Grossman School of Medicine is home to many key advancements in medical education. In 1854, human dissection in New York was legalized due to efforts of the faculty. In 1866, NYU professors pro ...
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Kidney Failure
Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; and chronic kidney failure, which develops slowly and can often be irreversible. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, high blood potassium, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anemia. Causes of acute kidney failure include low blood pressure, blockage of the urinary tract, certain medications, muscle breakdown, and hemolytic uremic syndrome. Causes of chronic kidney failure include diabetes, high blood pressure, nephrotic syndrome, and polycystic kidney disease. Diagnosis of acute failure ...
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Aspiration Pneumonia
Aspiration pneumonia is a type of lung infection that is due to a relatively large amount of material from the stomach or mouth entering the lungs. Signs and symptoms often include fever and cough of relatively rapid onset. Complications may include lung abscess, acute respiratory distress syndrome, empyema, and parapneumonic effusion. Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs. Infection can be due to a variety of bacteria. Risk factors include decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, and poor oral health. Diagnosis is typically based on the presenting history, symptoms, chest X-ray, and sputum culture. Differentiating from other types of pneumonia may be difficult. Treatment is typically with antibiotics such as clindamycin, meropenem, ampicillin/sulbactam, or moxifloxacin. For those with only chemical pneumonitis, antibio ...
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Pulmonary Aspiration
Pulmonary aspiration is the entry of material such as pharyngeal secretions, food or drink, or stomach contents from the oropharynx or gastrointestinal tract, into the larynx (voice box) and lower respiratory tract, the portions of the respiratory system from the trachea (windpipe) to the lungs. A person may inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe". Consequences of pulmonary aspiration range from no injury at all, to chemical pneumonitis or pneumonia, to death within minutes from asphyxiation. These consequences depend on the volume, chemical composition, particle size, and presence of infectious agents in the aspirated material, and on the underlying health status of the person. In healthy people, aspiration of small quantities of material is common and rarel ...
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Esophageal Dysphagia
Esophageal dysphagia is a form of dysphagia where the underlying cause arises from the body of the esophagus, lower esophageal sphincter, or cardia of the stomach, usually due to mechanical causes or motility problems. Signs and symptoms Patients usually complain of dysphagia (the feeling of food getting stuck ''several seconds'' after swallowing), and will point to the suprasternal notch or behind the sternum as the site of obstruction. Causes If there is dysphagia to both solids and liquids, then it is most likely a motility problem. If there is dysphagia initially to solids but progresses to also involve liquids, then it is most likely a mechanical obstruction. Once a distinction has been made between a motility problem and a mechanical obstruction, it is important to note whether the dysphagia is intermittent or progressive. An intermittent motility dysphagia likely can be diffuse esophageal spasm (DES) or nonspecific esophageal motility disorder (NEMD). Progressive motility d ...
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Oropharyngeal Dysphagia
Oropharyngeal dysphagia arises from abnormalities of muscles, nerves or structures of the oral cavity, pharynx, and upper esophageal sphincter. Signs and symptoms Some signs and symptoms of swallowing difficulties include difficulty controlling food in the mouth, inability to control food or saliva in the mouth, difficulty initiating a swallow, coughing, choking, frequent pneumonia, unexplained weight loss, gurgly or wet voice after swallowing, nasal regurgitation, and dysphagia (patient complaint of swallowing difficulty). Other symptoms include drooling, dysarthria, dysphonia, aspiration pneumonia, depression, or nasopharyngeal regurgitation as associated symptoms. When asked where the food is getting stuck patients will often point to the cervical (neck) region as the site of the obstruction. Complications If left untreated, swallowing disorders can potentially cause aspiration pneumonia, malnutrition, or dehydration. Diagnosis Oropharyngeal dysphagia is going to be suspected ...
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Phagophobia
Phagophobia is a psychogenic dysphagia, a fear of swallowing.Shapiro J, Franko DL, Gagne A. Phagophobia: a form of psychogenic dysphagia. A new entity. Ann Otol Rhinol Laryngol 1997; 106: 286-290. It is expressed in various swallowing complaints without any apparent physical reason detectable by physical inspection and laboratory analyses. An obsolete term for this condition is choking phobia, but it was suggested that the latter term is confusing and it is necessary to distinguish the fear of swallowing (i.e., of the propulsion of bolus) from fear of choking. Phagophobia is classified as a specific phobia and according to DSM-IV classification it belongs to the category of "other phobias". Phagophobia may lead to (and be confused with) fear of eating, and the subsequent malnutrition and weight loss. In milder cases a phagophobe eats only soft and liquid foods. See also *Odynophagia *Pseudodysphagia *List of phobias The English suffixes -phobia, -phobic, -phobe (from Greek ...
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Psychogenic Disease
Classified as a "conversion disorder" by the DSM-IV, a psychogenic disease is a disease in which mental stressors cause physical symptoms of different diseases. The manifestation of physical symptoms without biologically identifiable causes results from disruptions of processes in the brain from psychological stress. During a psychogenic disease, neuroimaging has shown that neural circuits affecting functions such as emotion, executive functioning, perception, movement, and volition are inhibited. These disruptions become strong enough to prevent the brain from voluntarily allowing certain actions (e.g. moving a limb). When the brain is unable to signal to the body to perform an action voluntarily, physical symptoms of a disease are presented even though there is no biological identifiable cause. Examples of diseases that are believed by many to be psychogenic include psychogenic seizures, psychogenic polydipsia, psychogenic tremor, and psychogenic pain. The term ''psychogenic dise ...
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Globus Pharyngis
Globus pharyngis or globus sensation is the persistent but painless sensation of having a pill, food bolus, or some other sort of obstruction in the throat when there is none. Swallowing is typically performed normally, so it is not a true case of dysphagia, but it can become quite irritating. It is common, with 22–45% of people experiencing it at least once in their lifetime. Causes The "lump in the throat" sensation that characterizes globus pharyngis is often caused by inflammation of one or more parts of the throat, such as the larynx or hypopharynx, due to cricopharyngeal spasm, gastroesophageal reflux (GERD), laryngopharyngeal reflux or esophageal versatility. In some cases the cause is unknown and symptoms may be attributed to a psychogenic cause ''i.e.'' a somatoform or anxiety disorder. It has been recognised as a symptom of depression, which responds to anti-depressive treatment. The results of recent studies have strongly suggested that GERD is a major cause of g ...
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University Of Texas Medical Branch
The University of Texas Medical Branch (UTMB) is a public academic health science center in Galveston, Texas. It is part of the University of Texas System. UTMB includes the oldest medical school in Texas, and has about 11,000 employees. In February 2019, it received an endowment of $560 million. Established in 1891 as the University of Texas Medical Department, UTMB has grown from one building, 23 students and 13 faculty members to more than 70 buildings, more than 2,500 students and more than 1,000 faculty. It has four schools, three institutes for advanced study, a comprehensive medical library, four on-site hospitals (including an affiliated Shriners Hospital for Children), a network of clinics that provide primary and specialized medical care and numerous research facilities. UTMB's primary missions are health sciences education, medical research (it is home to the Galveston National Laboratory) and health care services. Its emergency department at John Sealy Hospital is ...
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Odynophagia
Odynophagia is pain when swallowing. The pain may be felt in the mouth or throat and can occur with or without difficulty swallowing. The pain may be described as an ache, burning sensation, or occasionally a stabbing pain that radiates to the back. Odynophagia often results in inadvertent weight loss. The term is from ''-'' 'pain' and ' 'to eat'. Causes Odynophagia may have environmental or behavioral causes, such as: * Very hot or cold food and drinks (termed cryodynophagia when associated with cold drinks, classically in the setting of cryoglobulinaemia). * Taking certain medications * Using drugs, tobacco, or alcohol * Trauma or injury to the mouth, throat, or tongue It can also be caused by certain medical conditions, such as: * Ulcers * Abscesses * Upper respiratory tract infections * Inflammation or infection of the mouth, tongue, or throat (esophagitis, pharyngitis, tonsillitis, epiglottitis) * Immune disorders * Oral or throat cancer See also * Phagophobia Phagophobia ...
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