Odynophagia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

If left untreated, patients with odynophagia may progress to develop weight loss, malnutrition, and food aversion.

Prognosis is generally excellent, and the mortality/survival rate of patients with odynophagia depend on the primary cause.

Natural History, Complications, and Prognosis

Natural History

• If left untreated, patients with odynophagia may progress to develop weight loss, malnutrition, and food aversion.
• However the causes of odynophagia have their own independent course of progression and complication. 

Complications

• Common complications of odynophagia depend on the treatment and progress of primary disease, which may include:
  • URTI: LRTI, toxemia, meningitis, pneumonia, Otitis, orbital infections, systemic infections, encephalitis
  • GERD: Stricture,weight loss, Barrett's esophagus, Erosive esophagitis, Esophageal ulcer, Esophageal adenocarcinoma.
  • Tumor: Metastasis, narrowing of food passage, weight loss, DVT.
  • Foreign body:local inflammation, non invasive and invasive infections.
  • Esophagitis: Weight loss, superimposed bacterial infections, stricture.

Prognosis

• Prognosis is generally excellent, and the mortality/survival rate of patients with odynophagia depend on the primary cause.
  • Tumors: Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. Adenocarcinoma has better prognosis compared to squamous cell cancers.
  • URTI: Prognosis is generally excellent. Viral URTI's have better outcomes compared to Bacterial URTI's.
  • GERD: Prognosis is generally good. Untreated 20% may develop esophageal strictures.
  • Foreign body: Prognosis is generally excellent, if timely foreign body is removed from food pipe.
  • Esophagitis: Prognosis is generally good. It mostly depend on the cause of esophageal inflammation. Viral infections recover earlier with less complications compared to autoimmune, bacterial and chemical causes.