Dysphagia

224 Dysphagia



Instruction


This patient has difficulty in swallowing; would you like to ask her a few questions and examine her?



Salient features



History




• Ask about the following:


• The duration of symptoms: progressive dysphagia over months or weeks suggests the presence of organic narrowing (carcinoma esophagus, stricture from ongoing reflux esophagitis)

• Whether the difficulty is in swallowing liquids or solids, or both. (liquids first then motility disorder, solids first then suspect oesophageal stricture)

• Nasal regurgitation

• Whether or not the patient coughs on swallowing

• Is it difficult to make the swallowing movement (bulbar palsy)

• Is the swallowing painful: odynophagia (oesophageal ulcer, spasm or cancer)

• Is it intermittent (spasm of oesophagus)?

• The level at which the food sticks (suprasternal notch or midsternal)

• Does the neck distend or gurgle on swallowing (pharyngeal pouch)?

• Associated heart burn

• Weight loss.


Examination




• Examine:


• Mouth for ulcers, thrush and pallor

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Dec 4, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Dysphagia

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