DYSPHAGIA

DIVISI GASTROENTEROHEPATOLOGY

SMF ILMU PENYAKIT DALAM

FK UNAIR - RSUD DR. SOETOMO SURABAYA

2021
 DEFINITION

• DYSPHAGIA REFERS TO:

• THE DIFFICULTY SOMEONE MAY HAVE WITH THE INITIAL PHASES OF A SWALLOW (USUALLY
DESCRIBED AS “OROPHARYNGEAL DYSPHAGIA”) OR
• THE SENSATION THAT FOODS AND OR LIQUIDS ARE SOMEHOW BEING OBSTRUCTED IN THEIR
PASSAGE FROM THE MOUTH TO THE STOMACH (USUALLY DESCRIBED AS “ESOPHAGEAL
DYSPHAGIA”).

• DYSPHAGIA IS THUS THE PERCEPTION THAT THERE IS AN IMPEDIMENT TO THE NORMAL

PASSAGE OF SWALLOWED MATERIAL.
• FOOD IMPACTION IS A SPECIAL SYMPTOM THAT CAN OCCUR INTERMITTENTLY IN THESE
PATIENTS.
PHYSIOLOGICAL
MECHANISM

https://tracheostomyeducation.c
om/normal-swallowing/
 KEY FEATURES TO CONSIDER IN THE
MEDICAL HISTORY

 LOCATION
 TYPES OF FOODS AND/OR LIQUIDS
 PROGRESSIVE OR INTERMITTENT
 DURATION OF SYMPTOMS
 OROPHARYNG DYSPHAGIA
MECHANICAL AND OBSTRUCTIVE
CAUSES: NEUROMUSCULAR DISTURBANCES

 INFECTIONS (E.G., RETROPHARYNGEAL ABSCESSES)  CENTRAL NERVOUS SYSTEM DISEASES

 THYROMEGALY SUCH AS STROKE, PARKINSON DISEASE,
 LYMPHADENOPATHY CRANIAL NERVE PALSY, OR BULBAR PALSY
 ZENKER DIVERTICULUM (E.G., MULTIPLE SCLEROSIS, MOTOR
 REDUCED MUSCLE COMPLIANCE (MYOSITIS, FIBROSIS, NEURON DISEASE), AMYOTROPHIC
CRICOPHARYNGEAL BAR)
LATERAL SCLEROSIS
 EOSINOPHILIC ESOPHAGITIS
 HEAD AND NECK MALIGNANCIES AND THE  CONTRACTILE DISTURBANCES SUCH AS
CONSEQUENCES (E.G., HARD FIBROTIC STRICTURES) OF
MYASTHENIA GRAVIS, OCULOPHARYNGEAL
SURGICAL AND/OR RADIOTHERAPEUTIC INTERVENTIONS
ON THESE TUMORS MUSCULAR DYSTROPHY, AND OTHERS
 CERVICAL OSTEOPHYTES
 OROPHARYNGEAL MALIGNANCIES AND NEOPLASMS
(RARE)
ESOPHAGEAL DYSPHAGIA
 MANAGEMENT
OROPHARYNGEA
L DYSPHAGIA
http://www.worldgas
troenterology.org/Us
erFiles/file/guideline
s/dysphagia-english-
2014.pdf
TREATMENT APPROACH OF OD
MANAGEMENT OF ED
MANAGEMENT OPTIONS OF ACHALASIA
RESUME
Zenker's diverticulum
Jackhammer esophagus
Antireflux device