Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of dysphagia in the elderly ("presbyphagia") is probably still underestimated, though this disorder represents a major geriatric problem; special attention is necessary to prevent malnutrition, dehydration and aspiration pneumonia. Primary presbyphagia due to physiological, age-related changes of the swallowing mechanism must be differentiated from secondary presbyphagia attributable to diseases which are more frequent in the elderly. Transnasal pharyngo-laryngo-fiberendoscopy, videofluoroscopy and the "modified barium swallow" are of particular value in the diagnostic approach to presbyphagia. The possibilities of treatment are limited. They are aimed at dietary adjustments, compensatory mechanisms based on the properties of the volume and consistency of the food, proper feeding position and help by other persons. Individual swallowing exercises by a speech therapist are particularly valuable. Surgical procedures for the treatment of underlying organic disorders are less often indicated in presbyphagia.
 ...
PMID:[Dysphagia in the elderly]. 176 68

To determine the prevalence of swallowing and esophageal complaints in the general population, 300 men and 300 women were asked to answer a mailed questionnaire. The participation rate was 92.5%. Complaints were reported by 35%. The most common complaints were symptoms associated with gastroesophageal reflux (GER) and globus sensation, both with a rate of occurrence of 20%. Obstruction of the bolus reported by 3% was the individual symptom that most frequently brought patients to the doctor. To validate the questionnaire and to study possible organic causes behind these symptoms, 46 persons with symptoms were invited to undergo further examination. Cineradiography of the pharynx revealed that 7 of 14 patients with symptoms of GER had abnormalities in the esophagus. Eleven of 55 patients with GER symptoms at least once a week underwent endoscopy. One case of erosive esophagitis and one case of gastric ulcer were diagnosed. Four of nine patients with obstructive symptoms had defective closure of the laryngeal vestibule shown by cineradiography. Endoscopy in four patients with obstructive symptoms revealed benign findings. Thus, an epidemiologic study of patients with swallowing symptoms documented a low incidence of serious organic disease.
Dysphagia 1991
PMID:Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. 177 94

Unusual problems in oesophageal surgery in childhood include problems seen both frequently and infrequently. The former includes oesophageal atresia, peptic oesophagitis and corrosive oesophagitis; the latter includes such conditions as neonatal rupture of the oesophagus, explosive rupture of the oesophagus, achalasia of the cardia, pharyngo-oesophageal fibromatosis, nasogastric intubation stricture and stricture in the immunologically compromised patient. Examples of all of these conditions have been presented and reference has also been made to a wide variety of other conditions which have been reported in the literature. Because diagnostic delay is relatively common it is important for the paediatric surgeon carefully to evaluate the symptom of dysphagia when it is present and appreciate the fact that although organic disease in childhood is relatively uncommon there are many conditions which demand diagnosis and appropriate treatment.
 ...
PMID:Unusual problems in oesophageal surgery in childhood. 190 83

Symptoms of masked depression are often localised in the otorhinolaryngeal field. Headache, facial pain, dysphagia, burning sensations in the tongue, tinnitus, vertigo and voice and respiratory disorders were frequent complaints of 48 patients at our out-patient clinic between 1980 and 1985. After careful exclusion of organic disease, they proved to be due to endogenous depressive disorder. An increase in the number of such cases has been noted. One patient is described as an example of the problems of diagnosis.
 ...
PMID:[Otorhinolaryngologic manifestations of masked mono- or oligosymptomatic depressions]. 317 Feb 84

Symptoms of dysphagia and chronic vomiting often are categorized as being elicited by psychogenic factors, when no explanation can be found by fluoroscopic and endoscopic means. Psychogenic factors were also thought to be of aetiological significance in 58 patients referred under the diagnoses "psychogenic", "psychosomatic", and "functional" swallowing disorder, "psychogenic vomiting", "conversion neurosis", "anorexia nervosa", "psychosomatic disturbances in pregnancy", "cancer phobia", "cardiac phobia (DaCosta syndrome)", and "depressive disorder" to the Psychophysiology Unit, University of Vienna, for further evaluation. However, manometric, pH-metric, and endoscopic investigations showed that all of these patients suffered in fact from organic disorders: 36 from achalasia, 5 from vigorous achalasia, 5 from diffuse oesophageal spasms, 6 from lower oesophageal contraction abnormalities, one from pharyngo-oesophageal dyscoordination, one from a gastric ulcer ad cardiam, and 4 from gastro-oesophageal refluxes of whom one also had a hypertonic upper oesophageal sphincter. These findings, together with the fact that all concepts relating swallowing disorders to psychogenic factors have remained purely speculative, show that it is not justifiable to label dysphagic symptoms, for which no organic aetiology can be detected, as "psychogenic" or "psychosomatic". Patients with such symptoms should be studied by means of oesophageal manometry and/or pH-metry to reveal the nature of their disorder and to enable adequate therapy.
 ...
PMID:[Differential diagnosis of psychosomatic deglutition disorders]. 378 84

Four hundred fifty consecutive patients with dysphagia were evaluated radiologically over a 14-month period; 127 of these (28.2%) were also examined endoscopically. The most common abnormality seen was dysmotility (34%), followed by hiatal hernia, benign stricture, and esophagitis. Correlation with endoscopy was generally good. Radiologic study demonstrated all cases of esophageal malignancy; radiologic/endoscopic correlation was also strong in patients with moderate or severe esophagitis, though the radiologist had some difficulty detecting mild inflammation. Endoscopy failed to demonstrate some benign strictures. Radiologic study was relatively accurate in detecting significant organic disease; most motility disorders were not detected by endoscopy. For these reasons, as well as lower cost, increased convenience, and patient comfort, radiologic assessment is recommended as the primary method of evaluating patients with dysphagia.
 ...
PMID:Radiological assessment of dysphagia with endoscopic correlation. 405 45

Fifty-eight consecutive patients were investigated for spontaneous chest pain without symptoms of effort angina, previous myocardial infarction or other signs of cardiac disease, to determine the incidence of oesophageal spasm. The character of the chest pain, its context and the results of resting ECGs were analysed. An ECG recorded during chest pain was available in 23 cases and exercise stress testing was performed in 43 cases. Coronary angiography was carried out in all patients. The coronary arteries were normal or showed little change in 44 patients. Further investigations were ordered: oesophageal manometry (42 cases), echocardiography 44 cases) and ergometrine provocation tests (44 cases). The patients were then divided into 4 groups: 23 patients (40 p. 100) with coronary artery disease; either atheroma (14 cases) or spasm (9 cases); 8 patients (13,5 p. 100) with non-coronary cardiac pathology (myocardial hypertrophy or mitral valve prolapse); 15 patients (26 p. 100) with oesophageal spasm alone; 12 patients (20,5 p. 100) with no obvious organic disease. Often simulating spontaneous angina, clinically and electrocardiographically, oesophageal spasm may sometimes be distinguished (6 out of 15 cases) by the finding of painful dysphagia on swallowing ice-cold liquid. The condition is confirmed by oesophageal manometry which shows abnormalities of oesophageal contraction. In addition, 13 out of 15 patients in our series had hypotonia of the gastro-oesophageal sphincter. Dyskinetic phenomena and this hypotonia should be taken into consideration in the treatment of this condition.
 ...
PMID:[Esophageal spasm: a common cause of spontaneous precordial pain]. 643 62

Functional disorders mainly occur in young, anxious hyperactive, sometimes obsessional patients and involve all parts of digestive tract: feeling of obstruction the upper oesophagus or dysphagia; aerophagia related to a slow gastric emptying or gastric fullness relieved by eructation; biliary vomiting and pain in right abdominal upper quadrant which might correspond to a form of migraine without headache; irritable bowel, characterized by abdominal discomfort and constipation. Obviously, the diagnosis of functional disorders required elimination of an organic disease by appropriate endoscopic investigations. Psychosomatic disorders mainly comprise gastroduodenal ulcers and inflammatory bowel diseases. Although psychologic profiles have been associated with gastro-duodenal ulcer, these are not necessary for the development of the disease. The role of emotional factors has decreased since very efficient anti-secretory drugs are available. Inflammatory bowel diseases, in particular ulcerative colitis is frequently associated to behaviour disorders. The patient is usually a young woman brought up by an overprotective family. It is generally recognized that attacks of ulcerative colitis may be triggered by emotional factors. Thus, Stress may interact with digestive tract. In some cases, as in patients with irritable bowel or distal ulcerative colitis, psychotherapy such as Schultz's Autogenous Training, improves the patient's condition.
 ...
PMID:[Stress and the digestive system]. 828 96

This case report presents a patient with progressive dysphagia, accompanied by weight loss, in the absence of organic disease. Esophageal motility studies initially failed to reveal a diagnosis. At simultaneous manometry and fluoroscopy, with bread/barium boluses, the diagnosis of esophageal spasm in a relatively weak esophagus was made. All conservative treatment modalities failed. Thoracoscopic myotomy resulted in partial field of symptoms. Finally, an esophagectomy was performed because of sever dysphagia accompanied by persisting weight loss.
 ...
PMID:Low-amplitude distal esophageal spasm as a cause of severe dysphagia for solid food. 856 Nov 16

Swallowing function may be impaired by a number of conditions involving primary or associated emotional distress. When psychogenic dysphagia is suspected, routine investigation using radiological and manometric examination is inappropriate. These cases demand an evaluation of the individual as a whole, comprising the disease as well as the patient's personal problems and concerns. Five cases of patients complaining of swallowing difficulty and showing concurrent emotional distress were studied. Four individuals were anxious and one was depressed. Because of our approach a close medical-patient relationship was established. Afterwards, an explanation about the normal swallowing mechanisms and the role of the emotions was provided. All patients showed improvement of the symptom in the next 24 hours. Dysphagia can be found in anxiety, depression and conversion hysteria, with high incidence in the urban population of the third world countries. However, several professionals are unaware of these disorders. Our results suggest that this simple approach is an useful tool in managing dysphagic patients and its has validity even in individuals bearing dysphagia due to comproved organic disease. The results also emphasize the importance of the medical-patient relationship and the utility of a hollistic evaluation of the disease.
 ...
PMID:[Dysphagia and emotional distress]. 910 70


1 2 Next >>