Frequently Asked Questions (FAQs) on dysphagia | HospitalKhoj

DYSPHAGIA

DYSPHAGIA

Ques. 1 What is Dysphagia?
Ans. Difficulty in swallowing (deglutition) of food and drink.
Cases of Dysphagia Verbal :
I. Pain-tuberculous ulcers of tongue, pharyngitis, carcinoma of oesophagus, achalasia etc.
II. Vomiting – (a) Blood-stained with foods taken previously-carcinoma, (b) only the foods-Achalasia.
III. Changes in voice- Advanced carcinoma of oesophagus or thyroid, Bulbar palsy.
IV. Loss of weight-malignancy.
V. Acute onset – Impaction of foreign body, pharyngitis etc. Comparatively short history – carcinoma of tongue, thyroid etc. or Plummer – Vinson Syndrome. Long history – Achalasia. 

Ques. 2 What is the physical examination, Diagnosis and treatment of Dysphagia?
Ans. Physical Examination :
1. Soft palate palsy, Bulbar palsy.
2. Tonsils-tonsillitis, quinsy.
3. Neck – (i) any enlargement of thyroid gland, (ii) tracheal tuggings, (iii) swelling near clavicle, (iv) any tenderness and deformity of spine.
4. Chest – (i) Heart – pericardial effusion, (ii) Media-stinum-growth, (iii) Lung-tuberculous lesion, (iv) any aneurysm of aorta.
5. General-for anaemia and koilonychias.
6. Mouth – (i) stomatitis, (ii) any ulceration in the tongue, e.g. tuberculous ulcer, malignant ulcer, glossitis etc.
7. Pharyn-(i) any growth, (ii) any inflammation.
Diagnosis :
a) Vomiting with dysphagia commonly occurs in cardiospasm and oesophageal diverticula.
b) H/o ingestion of corrosives indicate a cicatricial stenosis.
c) Progress-patients with achalasia usually have a long history with remissions. Dysphagia firstly for solids and later for fluids suggests mechanical obstrucrion. Reverse is true for achalasia.
d) A history of heamatemesis suggests carcinoma or oesophagitis.
e) Hoarseness of voice suggests carcinoma of larynx.
f) Nasal regurgitation of fluids is frequently encountered in cases of palatal paralysis.
g) Posture- In oesophageal hiatus hernia dysphagia occurs in recumbent position and is relieved in upright position.
h) Onset-Sudden onset is suggestive of a foreign body, encephalitis, cerebellar thrombosis or hysterical spasm. Gradual onset is suggestive of stricture, carcinoma and achalasia.
i) Age – In children, dysphagia is mostly due to cleft palate, foreign body or diphtheria. In young females-Plummer-Vision syndrome, achalasia cardia or hysterical spasm.
Special Examination or Investigations :
i. X-ray of chest for-(a) aortic aneurysm, (b) mediastinal growth, (c) pericardial effusion, (d) lung T.B. (e) deformity of spine etc.
ii. Exfoliative cytology.
iii. Oesophagoscopy with biopsy.
iv. Laryngoscopy – for any ulceration of tumour of larynx.
v. Barium swallow X-ray-to visualize the abnormal-lities e.g. cardiospasm, stricture, tumours, oesopeageal diverticula etc.
vi. Biopsy.
vii. Blood – T.C., D.C., E.S.R., Hb%.
viii. Vomitus for malignant cells.
Treatment : The treatment of dysphagia depends on aetiology. Homoeopathic Remedies for treatment of Dysphagia.

Ques. 3 Which medicines are good for this case?
Ans. 1) SILICEA – Tongue dry or coated with a slimy mucous, swollen and numb ; difficult swallowing, rigors and suppuration.
2) COLCHICUM- Dysphagia, pain in throat larynx and muscles of neck; constriction in oesophagus, with accumulation of mucous in the throat, which come involuntarily into mouth or is hawked up.
3) CONIUM- Soreness of tongue, esp. about the root ; stiff, swollen, painful tongue, with dryness of mouth and impeded deglutition.
4) MERCURIUS – Dysphagia, he has to press hard to get something down, aching pains in oesophagus; difficulty of swallowing with danger of suffocation; liquids are ejected through nose.

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Comments   

# Rohan 2017-05-11
Hello, plz let me know Can gonorrhoea be transmitted to small children, should I consult with good maternity doctor in South Tripura
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# Dr. Naresh 2017-05-12
yes,this can be transmitted by infected mothers to children, In this case it is called as ophthalmia neonatorum, find list of good doctor-.Obstetrician in South Tripura
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# Harikiran 2017-04-19
Hii can you plz tell me, Which fluids can cause or spread syphilis infection, alos give me the list of good gynec in Haveri?
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# Dr. Naresh 2017-04-20
Infection from semen, blood or lactation milk can occur and cause syphilis, Infection from blood syringes is very common, Infected mothers can transmit it through their milk also, consult with good Gynecologist in Haveri .
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# Vaibhav 2017-04-17
Hi, plz let me know What is the incubation period of Syphilis, also give me the list of good female's specialist in Jalor ?
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# Dr. Naresh 2017-04-18
Hii, The incubation period can be 10 to 90 days, plz find list of Gynecologist in Jalor
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