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Paucis Verbis card: Dysphagia

Posted Dec 03 2010 12:00am
Dyphagia is a disorder of swallowing. It actually occurs in up to 10% of adults older than 50 years old. How can you determine the most likely causes for dysphagia? The secret is to obtain a thorough history and using the algorithm below, which I find really helpful from a review article in American Family Physician.

How do you read the figure?
  • Determine first if patient has oropharyngeal vs esophageal dysphagia. 
  • Determine if mechanical (problem is solid foods only) vs neuromuscular (problem with liquids and solids)is more likely.
Tip
  • Medications can cause dysphagia from esophageal mucosal injury or reduced lower esophageal sphincter tone.
  • CVA is most common cause of oropharyngeal dysphagia
Workup
  • Endoscopy
  • Barium swallow
  • Consider esophageal pH probe, manometry
(click image to zoom in)

Feel free to download this card and print on a 4'' x 6'' index card.

[ MS Word ] [ PDF ] See  other Paucis Verbis cards .
Reference 
Spieker MR. Evaluating dysphagia. American Family Physician, 2000, 61(12), 3639-48. Read the  review article  online.
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