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Swallowing (cont.)

Medical Author:
Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Dysphagia At A Glance

  • Dysphagia means difficulty swallowing.

  • Swallowing is a complex action involving the muscles and nerves within the pharynx and esophagus, a swallowing center in the brain, and nerves that connect the pharynx and esophagus to the swallowing center.

  • Dysphagia should be differentiated from odynophagia and globus sensation.

  • General causes of dysphagia can be grouped as either oropharyngeal or esophageal. Specific causes include physical obstruction of the pharynx or esophagus, diseases of the brain, diseases of the smooth muscle of the esophagus, diseases of skeletal muscle of the pharynx, and miscellaneous diseases.

  • Symptoms of dysphagia may be swallowing-related or non-swallowing-related.

  • The differential diagnosis of dysphagia includes odynophagia and globus sensation, tracheo-esophageal fistula, rumination syndrome, gastroesophageal reflux disease (GERD), and heart disease.

  • Evaluation and diagnosis of the cause of dysphagia includes history, physical examination, endoscopy, X-rays, esophageal manometry, esophageal impedence, esophageal acid testing, and tests for the diagnosis of muscular dystrophy and metabolic myopathies.

  • The treatment of dysphagia depends primarily on its cause.

  • Newer diagnostic procedures for the evaluation and diagnosis of the cause of dysphagia include high resolution or 3D manometry and endoscopic ultrasonography.

REFERENCE: Feldman, M., Scharschmidt, B. F., Sleisenger, M. H., Klein, S. Sleisenger & Fordtran's Gastrointestinal and Liver Disease, W. B. Saunders Company, 1998.


Last Editorial Review: 4/28/2010


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