Friday, April 28, 2017

Dysphagia - Symptoms, causes and treatment

Understanding Dysphagia


Dysphagia is a medical term that means difficult to swallow. For people who experience this condition, the process of channeling food or drink from the mouth into the stomach will require more effort and longer time than the condition of a healthy person.
Dysphagia has the potential to become a serious threat to health. In some cases, patients can not even eat or drink at all because the symptoms of accompanying pain are already very severe.
In addition to swallowing difficulties, there are also some symptoms or other signs that may accompany, including:
  • Pain during swallowing
  • Food feels stuck in the throat or chest.
  • Choking or coughing when eating and drinking.
  • Getting rid of saliva constantly.
  • Weight loss.
  • Food that has been swallowed out again.
  • Stomach acids often rise to the throat.
  • Often heartburn.
  • The voice becomes husky.
  • Patients often cut food into small pieces due to difficulty swallowing or even avoiding certain foods.

What causes dysphagia?

There are many factors that can cause a person to have dysphagia, including:
  • Suffering from conditions that can make the esophagus (the food channel from the mouth to the stomach) narrow or esophagus obstructed, such as gastric acid, oral and throat cancers, eosinophilic oesophagitis, esophageal inflammation due to fungus by fungus or tuberculosis, or Zenker diverticulum Esophageal sac). In addition to these conditions, esophageal constriction may also be caused by radiotherapy side effects.
  • Suffering from congenital conditions, such as cerebral palsy, learning disorders, and cleft lip.
  • Suffers conditions that can disrupt the performance of the food booster muscles from the esophagus into the stomach, such as the illness of secrets and scleroderma. In addition to these two conditions, the age factor can also weaken the ability of muscles in swallowing.
  • Suffers conditions that can damage the nervous system in charge of controlling the swallowing process, such as dementia, Parkinson's disease, multiple sclerosis, motor neurone disease, stroke, brain tumor, and myasthenia gravis.
  • Suffers conditions that may interfere with breathing, such as chronic obstructive pulmonary disease.
  • Complications from head or neck injuries.

Diagnosis of Dysphagia

Do not ignore if you often feel difficulty in swallowing and immediately to the doctor. Treatment will be more effective if the diagnosis is done as soon as possible. In addition, early treatment will also reduce the risk of complications, such as weight loss, malanutrisi, dehydration, choking, or even pneumonia.
In addition to asking for symptoms that the patient feels, including the severity and how often the symptoms appear, the doctor will also check the body mass index to see if the patient is malnourished due to difficulty swallowing.
As a preliminary test, the doctor will usually tell the patient to drink water in a certain amount as soon as possible (water swallow test). Records of time gained as well as the amount of water swallowed can help the doctor assess the patient's ability to swallow. Some of these inspection methods may be performed:
Endoscopy. This check is done with the help of a special hose that is flexible and equipped with cameras and lights. Images captured by the camera will be visible to the doctor through the monitor screen. 
  • Endoscopy can be applied to check the condition of the upper respiratory cavity (nose to throat) or check the condition of the esophagus (throat to stomach).
  • Fluoroscopy. This examination uses X-rays and is guided by a special substance called barium.
  • Manometry. This examination aims to see how well the performance of esogafus by measuring the amount of pressure on the organ when swallowing. Manometry is aided by a catheter (a small special tube) equipped with a pressure sensor. In addition to seeing the function of the esophagus, this examination method can also be applied to measure the volume of acid flowing back from the stomach to ascertain whether it is caused by gastric acid disease by measuring gastric acid levels.

Treatment of Dysphagia

Knowing the underlying cause of dysphagia is crucial to the success rate of treatment. In order for the process of swallowing food becomes easier, in addition to providing medication or applying certain treatment procedures, doctors will also advise patients to switch from solid foods to liquid food.
If dysphagia is caused by heartburn and gastric acid then doctors usually prescribe drugs that prevent reflux or backflow of stomach acid into the esophagus. PPI (proton pump inhibitor) can help relieve symptoms of dysphagia caused by narrowing or scarring of the esophagus. If there is inflammation in the esophagus (esophagitis), then the administration of corticosteroid drugs will usually be done.
If dysphagia is caused by the presence of something that obstructs the esophagus, for example as a result of scar tissue formation or occurrence of narrowing within the canal, the endoscopic method may be applied in order to exclude an obstructing or can be done by increasing the diameter of the esophageal canal (dilatation).
If the esophageal obstruction is caused by a tumor, surgical procedures should be performed. Surgery can also be applied to cases of dysphagia caused by the illness of the secrets (conditions that cause the muscles in the esophagus to become very stiff). However, in the case of the secretion, the doctor may try to prescribe the botulinum toxin drug before surgery.
If dysphagia is caused by cerebral palsy, the disruption of the nervous system in charge of controlling the ingestion, or the disruption of the performance of the pushing muscles of feeding from the esophagus into the stomach, then therapy to improve swallowing should be performed under the guidance of the relevant expert.
In severe cases of dysphagia, the installation of a special tube to channel food in the patient's body may be done to prevent malanutrisi and dehydration.

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