Dysphagia - difficulty swallowing it and passing solids or liquids from the mouth to the stomach.Dysphagia - clinical symptom of diseases of the esophagus and pharynx, in adjacent organs or neurogenic swallowing disorders.The topic for today is dysphagia difficulty swallowing a man!
progressive difficulty in swallowing with time indicates a progressive disease - stricture (narrowing) of the esophagus (eg, cancer), as well as stricture in general (non-tumor origin, such as progressive scleroderma).If the severity of dysphagia remains at a constant level, that involve narrowing of the esophagus.If swallowing is difficult both solid and liquid food, the reason is violation of esophageal motility.Hiccups that accompanies dysphagia, points to defeat the distal esophagus.
Among the reasons a person dysphagia motility disorders: in scleroderma (decreased motility of the esophagus, the formation of inflammatory stricture), dermatomyositis, amyloidosis, stroke, Parkinson's disease, muscular dystrophy, multip
Zenker diverticula (bulging of the wall of the esophagus above the upper esophageal sphincter, complaints of patients to reverse flow of food into the oral cavity, nepryatno breath, tumor palpable degree in the neck), esophageal cancer, Candida esophagitis, compression from outside the anomalous divergenceright subclavian artery, mediastinal tuberculosis, compression of enlarged thyroid gland, cancer of the bronchi, lung abscess, pleural pericarditis, aortic aneurysm, paraesophageal hernia of an esophageal aperture card.
dysphagia If a person is accompanied by pain when swallowing - this odynophagia.It is usually accompanied by the following diseases: stomatitis, pharyngitis, glossitis, sore throat, mumps, paratonsillar, retropharyngeal abscess, oral cancer, erosive lichen planus of the oral cavity, pemphigus vulgaris, pemphigoid scar.It is also the cause of dysphagia can be neurasthenia (a feeling of a lump in the throat, but the swallowing is not broken, there is a feeling coma due to spasm of the upper esophageal sphincter), achalasia (esophageal), diabetic polyneuropathy, botulism.
Neurotic dysphagia can be observed in humans when ingested liquid food and lacking in swallowing solid;the degree of manifestation of functional dysphagia does not change with time.When organic dysphagia determined by its dependence on the density of the food.Zapivaniya water brings some relief.For relatively frequent causes of dysphagia include - foreign bodies embedded in the wall of the esophagus.When neuromuscular diseases of the esophagus symptom is constant violation of patency of food;half of patients are pain, dysphagia prior or accompanying, often reduced body weight, diagnosis is based on data from studies of radiation, endoscopy, ezofagotonometrii.
delay of food in the esophagus as a result of cardiospasm, achalasia, esophageal spasm gradually leads to expansion of the esophagus, this is the expansion of the liquid contents, and the remnants of food eaten the day before.The esophagus is extended, it becomes crimped with pronounced segmental contractions of its walls.As the disease progresses deeper peristalsis, aimed at restoring patency of the lower segment of the surface gives way, segmental reduction terminated, the esophagus becomes atonic.
post-burn esophageal strictures and regional non-specific constrictive esophagitis (Crohn's disease) manifest severe dysphagia and require differential diagnosis of tumor lesion.Dysphagia can also develop as a result of degenerative changes in the esophageal mucosa, which occurs in iron deficiency anemia, leukemia, agranulocytosis.From diagnostic procedures using X-ray examination, endoscopy with biopsy.
in the treatment of functional dyspepsia justified the use of eradication therapy of H. pylori, with dyskinetic form prescribed prokinetiki - blockers of dopamine receptors - metoclopramide (Reglan, Raglan), but this drug penetrates gemotoentsefalichesky barrier and causes 20% of cases side effects - drowsiness, fatigue, anxiety, extrapyramidal reactions, or motilium.New directions in the treatment of patients with PD - agonists to the receptor (fedototsin), 5-HT4 receptors (tegaserod), and gonadotropic releasing hormone (leuprolide), antagonists of the 5-NTZ receptors (ondansetron) receptors of cholecystokinin A (loksiglumid), tricyclic antidepressants andselective serotonin reuptake inhibitor.