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Latest revision as of 21:30, 29 July 2020

Dysphagia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]Kiran Singh, M.D. [3]

Overview

Dysphagia can be caused by many diseases such as neurological disorders, structural disorders of esophagus, tumors and motor disorders.

Causes

Depending upon the type of dysphagia, causes can be categorized into two subsections.[1][2][3][4]

Common Causes of Oropharyngeal Dysphagia

Common causes of oropharyngeal dysphagia
Neurological Medication side effects Others

Common causes of Esophageal Dysphagia

The common causes of esophageal dysphagia can be divided into four categories.[5][6][7][8][9]

Structural (Mechanical) disorders Motor disorders Esophageal tumors Systemic diseases Miscellaneous
Intrinsic compression Extrinsic Compression Primary Secondary
Mucosal rings and webs Strictures: Vascular compression:
  • Dysphagia lusoria (aberrant right subclavian artery)
  • Dysphagia aortica (right-sided aorta)
  • Cardio-megaly (enlarged left atrium)

Less Common Causes

Less common causes of dysphagia include:

  • Scleredema adultorum[10][11]
  • Post chemotherapy and radiation therapy[12]
  • Descending thoracic aorta aneurysm[13]
  • Hypertrophy of cricopharyngeal muscles[14]

Causes by Organ System

The causes of dysphagia based on the organ system are as follows:[15][16]

Cardiovascular Aberrant subclavian artery, amyloidosis, anomalous left pulmonary artery,aortic aneurysm, aortic arch anomalies, charge syndrome, double aortic arch, enlarged aorta, enlarged left atrium, hypokalemia, mitral valve stenosis, pericarditis, superior vena cava syndrome
Chemical / poisoning Arizona bark scorpion poisoning, arsenic poisoning, botulism, cobra poisoning, fluoride poisoning, lead poisoning
Dermatologic Behcet's syndrome, dermatomyositis, polymyositis, Stevens-Johnson syndrome, systemic lupus erythematosus
Drug Side Effect Antipsychotic medications, artemether and lumefantrin, atropine, botulinum toxin, bicalutamidechemotherapy, cyclosporine toxicity, cytarabine, dactinomycin, doxycycline, eletriptan, hydroxocobalaminhyoscyamine, ibandronate, ioxilan, ixabepilone, minocycline hydrochloride, nabumetone, neuroleptics, oxcarbazepine, pergolide, rimabotulinumtoxinb, riociguat, ropinirole, sargramostim, sertraline, scarlet fever, tiagabine
Ear Nose Throat Carcinoma of the vocal tract, cricopharyngeal spasm, eagle syndrome, epiglottitis, Impaired sensitivity in the larynx, laryngeal cancer, nasopharyngeal carcinoma, oral pharyngeal disorders, oral submucous fibrosis, palatine tonsil, pharyngeal pouch, pharyngitis, pharynx cancer, quinsy, retropharyngeal abscess, tonsillar cancer
Endocrine Cushing's syndrome, diabetic neuropathy, goiter, hyperthyroidism, hypokalemia, hypothyroidism, paraganglioma, Riedel thyroiditis, subacute granulomatous thyroiditis, thymoma, thyroglossal cyst, thyroid cancer, anaplastic,thyrotoxicosis, vagal paraganglioma, De Quervain's thyroiditis, solitary thyroid nodule
Environmental No underlying causes
Gastroenterologic Achalasia, adjustable gastric band, aerophagia, aspiration of foreign body, Barret's syndrome,candida esophagitis, cascade stomach, caustic esophagitis, Crohn's disease of the esophagus, diffuse esophageal spasm, diverticulum, eosinophilic esophagitis, eosinophilic gastroenteritis, esophageal atresia, esophageal cancer, esophageal cyst, esophageal diverticulum, esophageal leiomyoma, esophageal obstruction by a foreign body, esophageal pouch, esophageal spasm, esophageal stricture, esophageal web, esophageal moniliasis, esophageal sarcoidosis, esophageal trauma, esophagitis, esophagotracheal fistula, external esophageal compression, gastric cancer, gastric volvulus, gastritis, gastroesophageal reflux, gastrointestinal stromal tumor, gastroparesis, Gaucher disease, globus pharyngis, globus syndrome, hiatal hernia, hypertensive lower esophageal sphincter, infectious esophagitis, intramural pseudodiverticulosis, lymphocytic esophagitis, mitochondrial neurogastrointestinal encephalopathy syndrome, mucositis, myoneurogastrointestinal encephalopathy syndrome, nutcracker esophagus, odynophagia, peptic esophagitis, post surgery, peptic stricture, pharyngeal pouch, pill esophagitis, Plummer-Vinson syndrome, presbyphagia, pseudoachalasia, pyloric stenosis, radiation esophagitis, Schatzki ring, stomach cancer, upper oesophageal sphincter dysfunction, Wilson disease, zenker's diverticulum
Genetic Aberrant subclavian artery, achalasia-addisonian syndrome, achromatopsia, adrenoleukodystrophy, ataxia neuropathy spectrum,Behcet's syndrome, chromosome 1p36 deletion syndrome, chromosome 22 ring, chromosome 22 trisomy mosaic, connective tissue disease, crisponi syndrome, Emanuel syndrome  , extreme spinal curvature, Gaucher disease,Huntington disease, lissencephaly, type 1, x-linked , muscular dystrophy, Duchenne and Becker type ,myotonic dystrophy, nemaline myopathy1, oculopharyngeal muscular dystrophy, Opitz-frias syndrome, pseudoadrenoleukodystrophy, spinal muscular atrophy type I, spinocerebellar ataxia 17  , spinocerebellar ataxia 22, spinocerebellar ataxia, autosomal recessive 1, Stuve-wiedemann dysplasia, vascular ring with right aortic arch, Wiedemann–Rautenstrauch syndrome, Wilson disease
Hematologic Agranulocytosis, mononucleosis, Plummer-Vinson syndrome
Iatrogenic No underlying causes
Infectious Disease Abscess, angina tonsillaris, botulism, candida esophagitis, Chagas disease, cytomegalovirus, diphtheria, epiglottitis, gastritis, herpangina, herpes simplex virus, infectious esophagitis,laryngeal papillomatosis, lassa fever, Ludwig's angina, lyme disease, lymph granulomatosis, Lymphadenopathy,Medication-induced esophagitis, mumps, neonatal tetanus  , oral candidiasis, paracoccidioidomycosis, Pharyngitis, polio, poliomyelitis, postpolio syndrome, quinsy, rabies, retropharyngeal abscess, snakebites, stomatitis, syphilis, tetanus, tetrodotoxin, tonsillar abscess, ulcer, Vincent's angina
Musculoskeletal / Ortho cytoplasmic body myopathy, Diffuse idiopathic skeletal hyperostosis, distal myopathy 2, elongated styloid process, extreme spinal curvature, inclusion body myositis, muscular dystrophy, Duchenne and Becker type, osteophytes, Pierre Robin's sequence 
Neurologic 10th cranial nerve disorder, amyotrophic lateral sclerosis, Arnold–Chiari malformation, ataxia neuropathy spectrum, autonomic nerve disorders, autonomic neuropathy, autosomal recessive spastic paraplegia, type 11, Avellis syndrome, Babinski–Nageotte syndrome, basal ganglia disease, basilar artery insufficiency syndrome, brain stem gliomas, brainstem stroke, brainstem tumors, pseudobulbar palsy, bulbar palsy, Canomad syndrome, carotid paraganglioma, central pontine myelinosis, central vagal nucleus lesion, central hypoglossal nerve paralysis, cerebellar Infarction, cerebellar stroke, cerebral palsy, cerebrovascular accident, congenital myasthenic syndrome, cervical osteophytes, dementia, diabetic neuropathy, dystonia, epileptic encephalopathy, early infantile, 1, fosmn syndrome, Guillain-Barre Syndrome, head trauma, Huntington disease, infantile striato-thalamic degeneration, lateral funiculus angina, lateral medullary syndrome, Lhermitte-cornil-quesnel syndrome, lissencephaly, type 1, x-linked, metabolic encephalopathies, microcephaly, mitochondrial neurogastrointestinal encephalopathy syndrome, motor neuron disease, multiple sclerosis, multiple system atrophy, muscular dystrophy, Duchenne and Becker type, myasthenia gravis, myoneurogastrointestinal encephalopathy syndrome, myopathy, myotonic dystrophy, neuroferritinopathy, neurosarcoidosis, osmotic demyelination syndrome, Pallidopyramidal syndrome, paraganglioma, paraneoplastic limbic encephalitis, Parkinson disease, peripheral neuropathy, peripheral tongue paralysis, polyradiculitis, pontocerebellar hypoplasia type 2a, primary lateral sclerosis, adult, primary motility disorders, Pseudobulbar paralysis,pseudodysphagia, secondary motility disorders, Shy-Drager syndrome, spastic paraplegia 11, autosomal recessive, spinal muscular atrophy type I, spinocerebellar ataxia 17 , spinocerebellar ataxia 22 , spinocerebellar ataxia, autosomal recessive 1, striatonigral degeneration infantile, stroke, syringobulbia, tardive dyskinesia, vagus nerve palsy, Wallenberg's syndrome
Nutritional / Metabolic Adrenoleukodystrophy, amyloidosis, Gaucher disease, hydroxocobalamin, hypokalemia, Plummer-Vinson syndrome, Wilson disease
Obstetric/Gynecologic Leiomyoma
Oncologic Acoustic neuroma, brain stem gliomas, brain stem tumors, bronchial carcinoma, carcinoma of the vocal tract, carotid body tumor, chordoma, esophageal cancer, gastric cancer, laryngeal cancer, laryngeal carcinoma, leiomyoma, lymphadenopathy, malignant lung cancer, malignant mesothelioma, nasopharyngeal carcinoma, neck cancer, odontoma, Oral cavity tumor, oropharyngeal cancer, palate cancer, paraganglioma, paraneoplastic limbic encephalitis, paraneoplastic syndrome, pharynx cancer, small cell lung cancer, stomach cancer, supraglottic laryngeal cancer, throat cancer, thyroid cancer, anaplastic, tongue cancer, tonsillar cancer, vagal paraganglioma
Opthalmologic Achromatopsia, oculopharyngeal muscular dystrophy
Overdose / Toxicity Alcoholism
Psychiatric Anxiety disorders, dementia, frontotemporal dementia, functional disorders, global hystericus, rumination disorder, tardive dyskinesia
Pulmonary Bronchial carcinoma, congenital bronchogenic cyst, epiglottitis, malignant lung cancer, malignant mesotheliomamediastinal mass, mediastinitis, Ondine's curse, pharyngitis, pleuritis, sarcoidosis
Renal / Electrolyte Hypomagnesemia primary, hypophosphatemia, systemic lupus erythematosus
Rheum / Immune / Allergy Allergic swelling, amyloidosis, Behcet's syndrome, Canomad syndrome, cervical osteophytes, CREST syndrome, dermatomyositis, diffuse systemic sclerosi, fibrosis, graft-versus-host disease, inclusion body myositis, muscular dystrophy, oculopharyngeal muscular dystrophy, osteophytes, paraneoplastic syndrome, polymyalgia rheumatica, polymyositis, rheumatoid arthritis, sarcoidosis, scleroderma, stomatitis, systemic lupus erythematosus, systemic sclerosis, trismus
Sexual No underlying causes
Trauma Head trauma
Urologic No underlying causes
Dental Vincent's angina
Miscellaneous Franek-bocker-kahlen syndrome, palatoplegia, tongue conditions, vascular abnormality

References

  1. Starmer HM, Riley LH, Hillel AT, Akst LM, Best SR, Gourin CG (2014). "Dysphagia, short-term outcomes, and cost of care after anterior cervical disc surgery". Dysphagia. 29 (1): 68–77. doi:10.1007/s00455-013-9482-9. PMID 23943072.
  2. Inayat F, Hussain Q, Shafique K (2017). "Dysphagia Caused by Extrinsic Esophageal Compression From Mediastinal Lymphadenopathy in Patients With Sarcoidosis". Clin Gastroenterol Hepatol. 15 (7): e119–e120. doi:10.1016/j.cgh.2016.11.010. PMID 27840183.
  3. Oda K, Iwakiri R, Hara M, Watanabe K, Danjo A, Shimoda R; et al. (2005). "Dysphagia associated with gastroesophageal reflux disease is improved by proton pump inhibitor". Dig Dis Sci. 50 (10): 1921–6. doi:10.1007/s10620-005-2962-5. PMID 16187198.
  4. Roman S, Kahrilas PJ (2014). "The diagnosis and management of hiatus hernia". BMJ. 349: g6154. doi:10.1136/bmj.g6154. PMID 25341679.
  5. Xiao Y, Kahrilas PJ, Nicodème F, Lin Z, Roman S, Pandolfino JE (2014). "Lack of correlation between HRM metrics and symptoms during the manometric protocol". Am J Gastroenterol. 109 (4): 521–6. doi:10.1038/ajg.2014.13. PMC 4120962. PMID 24513804.
  6. Enestvedt BK, Williams JL, Sonnenberg A (2011). "Epidemiology and practice patterns of achalasia in a large multi-centre database". Aliment Pharmacol Ther. 33 (11): 1209–14. doi:10.1111/j.1365-2036.2011.04655.x. PMC 3857989. PMID 21480936.
  7. Howard PJ, Maher L, Pryde A, Cameron EW, Heading RC (1992). "Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh". Gut. 33 (8): 1011–5. PMC 1379432. PMID 1398223.
  8. Pandolfino JE, Gawron AJ (2015). "Achalasia: a systematic review". JAMA. 313 (18): 1841–52. doi:10.1001/jama.2015.2996. PMID 25965233.
  9. Gockel I, Lord RV, Bremner CG, Crookes PF, Hamrah P, DeMeester TR (2003). "The hypertensive lower esophageal sphincter: a motility disorder with manometric features of outflow obstruction". J Gastrointest Surg. 7 (5): 692–700. PMID 12850684.
  10. Chatterjee S, Hedman BJ, Kirby DF (2017). "An Unusual Cause of Dysphagia". J Clin Rheumatol. doi:10.1097/RHU.0000000000000666. PMID 29280826.
  11. Wright RA, Bernie H (1982). "Scleredema adultorum of Buschke with upper esophageal involvement". Am J Gastroenterol. 77 (1): 9–11. PMID 7064968.
  12. Nguyen NP, Sallah S, Karlsson U, Antoine JE (2002). "Combined chemotherapy and radiation therapy for head and neck malignancies: quality of life issues". Cancer. 94 (4): 1131–41. PMID 11920484.
  13. Conte, Blagio A. (1966). "Dysphagia Caused by an Aneurysm of the Descending Thoracic Aorta". New England Journal of Medicine. 274 (17): 956–957. doi:10.1056/NEJM196604282741710. ISSN 0028-4793.
  14. Benedict, Edward B.; Sweet, Richard H. (1955). "Dysphagia Due to Hypertrophy of the Cricopharyngeus Muscle or Hypopharyngeal Bar". New England Journal of Medicine. 253 (26): 1161–1162. doi:10.1056/NEJM195512292532607. ISSN 0028-4793.
  15. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  16. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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