DYSPHAGIA

Dysphagia - Definition and Classification

• Dysphagia is a medical term that describes difficulty swallowing.
• Dysphagia can be classified into two main types:
  • Oropharyngeal dysphagia: Difficulty swallowing due to problems in the mouth and pharynx.
  • Esophageal dysphagia: Difficulty swallowing due to problems in the esophagus.

Causes of Dysphagia

• Oropharyngeal dysphagia:
  • Stroke or brain injury
  • Neurodegenerative diseases (e.g., Parkinson's disease)
  • Head and neck cancer
  • Scleroderma
  • Cervical spine disorders
• Esophageal dysphagia:
  • Esophageal cancer
  • Esophageal stricture or narrowing
  • Gastroesophageal reflux disease (GERD)
  • Achalasia
  • Motility disorders

Clinical Features Suggestive of Dysphagia

• Difficulty swallowing solids and liquids
• Regurgitation of food
• Weight loss
• Choking or coughing during swallowing
• Pain or discomfort during swallowing
• Vocal cord paralysis

Systematic Clinical Examination for Dysphagia

• History taking:
  • Ask about symptoms, medical history, and dietary habits.
• Physical examination:
  • Inspection of the mouth, pharynx, and esophagus.
  • Palpation of the neck and throat.
  • Auscultation of the chest.
• Swallowing tests:
  • Water swallow test
  • Barium swallow test
  • Endoscopy

Differentiation between Oropharyngeal and Esophageal Dysphagia

• Oropharyngeal dysphagia:
  • Difficulty swallowing solids and liquids.
  • Regurgitation of food.
  • Weight loss.
  • Choking or coughing during swallowing.
• Esophageal dysphagia:
  • Difficulty swallowing solids more than liquids.
  • Pain or discomfort during swallowing.
  • Vocal cord paralysis.

Red Flag Signs in Dysphagia Requiring Urgent Intervention

• Sudden onset of dysphagia.
• Regurgitation of food or liquids.
• Choking or coughing during swallowing.
• Vocal cord paralysis.
• Weight loss.
• Pain or discomfort during swallowing.

Homoeopathic Therapeutic Medicines

• Dysphagia due to neurological causes:
  • Lachesis - Difficulty swallowing liquids.
  • Opium - Difficulty swallowing solids.
• Dysphagia due to esophageal causes:
  • Ipecacuanha - Difficulty swallowing due to esophageal spasm.
  • Ignatia - Difficulty swallowing due to anxiety or stress.