Clinical note: Diagnostic points of "dysphagia"

1.
Oropharyngeal dysphagia

It means that it is difficult for the esophagus to enter the esophagus from the pharynx, and the liquid is particularly difficult to pass through the pharynx, accompanied by nasal reflux, choking cough, etc
.

This is associated with dysfunction of the pharynx, hypopharynx, upper esophageal sphincter (UES), and esophageal rhabdom, making oropharyngeal dysphagia a manifestation of
neurological or muscular disease.

Multiple sclerosis, scleroderma, hyper- or hypothyroidism can cause dysfunction of the pharynx, hypopharynx and UES
.
The lesions of the rhabdomyosis muscle (such as dermatomyositis, polymyositis, muscle atrophy, etc.
) can affect the pharyngeal muscle and esophageal striated muscle, weakening the contraction of the pharyngeal muscle, reducing the pressure of UES and the amplitude of proximal esophageal contraction, all of which can cause oropharyngeal dysphagia
.

In younger patients, oropharyngeal dysphagia is often caused
by muscle disease, esophageal webbing, or oesophageal ring.
In older patients, it is often caused by central nervous system disorders, including stroke, Parkinson's disease, and dementia
.

2.
Esophageal dysphagia

It refers to the obstruction of the esophagus through the esophagus, which can be divided into two categories
: mechanical and dynamic.

(1) Mechanical: When swallowing large pieces or other solid foods, there is no difficulty
in swallowing drinks.
Esophageal tumors, benign strictures, enlarged mediastinal lymph nodes, or congenital aortic arch malformations can cause dysphagia, and sometimes esophageal cancer has not yet obstructed the esophagus, but has invaded the myometrial ganglion cells, causing dysmotilous dysphagia
.

(2) Dynamic: dysphagia is not divided into liquid and solid, mainly seen in achalasia, diffuse esophageal spasm, etc.
, sometimes hysteria
.