Dysphagia causes jotting

CAUSES OF DYSPHAGIA

NEUROMUSCULAR OBSTRUCTIVE

OROPHARYNGEAL CNS Tumours of

DYSPHAGIA - Bulbar (brainstem) paralysis – caused by - Tongue, buccal cavity, pharynx
cerebrovascular accidents, brainstem Inflammation
tumours, etc. - Stomatitis, tonsillitis,
- Parkinson’s dx pharyngitis, retropharyngeal
- Wilson dx abscess Ludwig’s angina; TB;
- Multiple sclerosis syphilis
PNS Plummer-Vinson syndrome = iron
- Poliomyelitis deficiency anaemia, dysphagia,
- Peripheral neuropathies caused by oesophageal stenosis, and atrophic
Diphtheria, Tetanus, DM, etc glossitis
Motor endplate
- Myasthenia gravis
Muscles of oropharynx -
- Dystrophy
- Myositis
- Metabolic myopathy (e.g. glycogen storage
dx, lipid storage dx)
Upper oesophageal sphincter disorders
- Incomplete relaxation (cricopharyngeal
Achalasia; oculopharyngeal muscular
dystrophy)
- Inadequate opening (cricopharyngeal bar;
Zenker diverticulum)
- Delayed relaxation (familiar dysautonomia)

OESOPHAGEAL Most common Congenital

DYSPHAGIA - Achalasia - Atresia; Stenosis; Webs; Rings
- Diffuse spasm of oesophagus (Schatski ring); Dysphagia
Others lucosuria
- Nutcracker oesophagus Acquired
- Hypertensive LES - Intraluminal - - Foreign body;
- Motility disorders 2ndary to – Scleroderma, Food obstruction
DM, Collagen dxos, & Chagas dx - Intramural - -

 Tumours (including
oesophageal carcinoma);

 Stricture (Corrosive stricture,

Inflammatory strictures caused
 by Reflux oesophagitis or
GERD, Radiation oesophagitis,
foreign body);

 Perforation

 Diverticular dx – Zenker
diverticulum

 Barret’s oesophagus

 Plummer-Vinson syndrome

OESOPHAGO- Achalasia - Gastric carcinoma of cardia,

GASTRIC fundus or upper lesser curvature
DYSPHAGIA - Gastric volvulus
- Stricture

PARAOESOPHAGEAL - Sublingual dermoid

/ EXTRAMURAL - Cervical spine dx
DYSPHAGIA - Thyromegaly / Goitre
(Hashimoto’s thyroiditis)
- Lymphadenopathy (cervical or
mediastinal)
- Mediastinal tumour
- Left atrial enlargement

Oropharyngeal dysphagia

- @ the level of oropharynx

- @ the voluntary phase of swallowing

Oesophageal dysphagia

- @ oesophageal level
- @ involuntary phase of swallowing

Neuro-muscular dysphagia

- There is paralysis or weakness of the oropharyngeal or oesophageal muscles leading to Esophageal Motility Disorder
(EMD)
- Commonest cause of oropharyngeal dysphagia

Obstructive dysphagia

- Dysphagia due to Obstruction of the oesophagus by luminal, intramural and extramural lesions

Zenker diverticulum (pharyngoesophageal diverticulum)

- Most common diverticulum of the oesophagus
- a pulsion diverticulum developing between the inferior pharyngeal constrictor and the cricopharyngeus muscle.

NOTE: Plummer-Vinson syndrome is a.k.a. Patterson-Kelly syndrome