| ICD-10 | R13. |
|---|---|
| ICD-9 | 787.2 |
| DiseasesDB | 17942 |
| MedlinePlus | 003115 |
| eMedicine | pmr/194 |
| MeSH | D003680 |
Dysphagia is the medical term for the symptom of difficulty in swallowing.[1][2][3] Although classified under "symptoms and signs" in ICD-10,[4] the term is sometimes used as a condition in its own right.[5][6][7] Sufferers are sometimes unaware of their dysphagia.[8][9]
It derives from the Greek root dys meaning difficulty or disordered, and phagia meaning "to eat". It is a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach.[10] Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing,[11] and globus, which is the sensation of a lump in the throat. A psychogenic dysphagia is known as phagophobia.
It is also worthwhile to refer to the physiology of swallowing in understanding dysphagia.
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Swallowing disorders can occur in all age groups, resulting from congenital abnormalities, structural damage, and/or medical conditions.[12] Swallowing problems are a common complaint among older individuals, and the incidence of dysphagia is higher in the elderly,[13] in patients who have had strokes,[14] and in patients who are admitted to acute care hospitals or chronic care facilities. Other causes of dysphagia include head and neck cancer and progressive neurologic diseases like Parkinson's disease, Dementia, Multiple sclerosis, Shy-Drager syndrome, or Amyotrophic lateral sclerosis. Dysphagia is a symptom of many different causes, which can usually be elicited by a careful history by the treating physician and a formal dysphagia evaluation performed by a speech-language pathologist.[15]
Dysphagia is classified into two major types: oropharyngeal dysphagia and esophageal dysphagia.[16] In some patients, no organic cause for dysphagia can be found, and these patients are defined as having functional dysphagia.
Some patients have limited awareness of their dysphagia, so lack of the symptom does not exclude an underlying disease.[12] When dysphagia goes undiagnosed or untreated patients are at a high risk of aspiration and subsequent aspiration pneumonia secondary to food or liquid going the wrong way into the lungs. Some pople present with "silent aspiration" and do not cough or show outward signs of aspiration. Undiagnosed dysphagia can also result in dehydration, malnutrition, and renal failure.
The gold-standard for diagnosing dysphagia in the United States and Countries of the Commonwealth are via a Modified Barium Swallow Study or Videoflouroscopic Swallow Study ( Fluoroscopy). This is a lateral video X-ray that provides objective information on bolus transport, safest consistency of bolus (honey, nectar, thin, pudding, puree, regular), and possible head positioning and/or manuevers that may facilitate swallow function depending on each individuals anatomy and physiology. This study is performed by a Speech-Language Pathologist and a Radiologist.
Each year, approximately ten million Americans are evaluated for swallowing disorders.[17]
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