Causes of Dysphagia ( Difficult Swallowing )

Here we will discuss the definition and causes of Dysphagia which is a common GIT symptom .

Definition: It means Difficulty in swallowing

Causes

A. Causes in the Mouth :

1. Stomatitis
2. Glossitis.
3. Neoplasm of Tongue & Cheek.

B. Causes in the Pharynx:

1. Pharyngitis.
2. Pharyngeal Diverticulum.
3.Retro-pharyngeal Abscess.

4.Tonsilitis.
5. Para-tonsiller Abscess.
6. Post-cricoid carcinoma
7.Plummer Vinson syndrome .

N.B Plummer-Vinson syndrome: (Rare)
· Incidence : Common with post-menopausal female.
· Aetiology : It iS due to Fe deficiency Anaema,

Characters : It is characterized by dysphagia (spasm), microcytic Anaemia, splenomegaly, Achlorohydria glossitis, Angular stomatitis and spooning of Nails.
Treatment 1.Dilatation for dysphagia.
2. Fe therapy for Anaemia

C. functional Causes:

1. Neuritis of-glossopharyngeal or vagus nerve.
2. Myasthenia gravis or Tetanus. Gl 3. Hysterical.
4. Motility disorders e.g. Corkscrew (Diffuse spasm)

N.B Diffuse oesophageal spasm: {Cork screw}
· The disease differs from achalasia by characteristic presence of multiple areas of spasm may be seen throughout the oesophagus.
- Corkscrew oesophagus presented with mild dysphagia with pain of swallowing felt mainly in the root of the neck.
• Treatment : Dilatation or long myotomy.

D. Causes in the Oesophagus :

• Causes in the Lumen:
e.g. Foreign bodies.

• Causes in the Wall
1. Congenital: Oesophageal Atresia. 2.Traumatic: Corrosive stricture.
3. Neuromuscular: Achalasia.
4. Hiatus Hernia.
5. Neoplastic : Carcinoma.
6. Inflammatory as Reflux Oesophagitis.

• Causes Outside the Wall
1. Malignant Thyroid .
2. Aortic Aneurysm.
3. Malignant L.Ns.
4. Dysphagia Lusoria

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