should be distinguished from the following two conditions
odynophagia : painful swallowing (frequently associated with dysphagia)
globus : sensation of a mass in the throat
can be grouped as :
oropharyngeal dysphagia
abnormalities of the initiation of swallowing reflex in the oropharynx
common in old age
commonest cause is stroke
oesophageal dysphagia
abnormalities of flow of the food bolus through the esophagus into the stomach
causes include:
achalasia, scleroderma,carcinomas, strictures
Key points (2):
new onset dysphagia in adults requires urgent direct access upper gastrointestinal endoscopy (to be done within two weeks); dysphagia associated with head and neck cancer red flags requires a suspected head and neck cancer pathway referral
in many cases malignancy is not found, but management of benign conditions, such as oesophageal dysmotility or gastro-oesophageal reflux, can be challenging
secondary sequelae of benign and malignant dysphagia include malnutrition and aspiration pneumonia: consider early input from dietetic and speech and language therapy teams
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