Dysphagia

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Dysphagia is "difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the pharynx and upper esophageal sphincter; and esophageal dysphagia due to malfunction of the esophagus."[1]

Diagnosis

Dysphagia among stroke patients is suggested by the following test:[2]

  1. First check the patient for "swallowing complaints, abnormalities of voice quality, facial asymmetry, or either expressive or receptive aphasia." If none is detected then go to step 2.
  2. Have the patient drink 10 mL of water from a cup without a straw while seated upright while oxygenation saturation is monitored during and for 2 minutes after the test. Check whether the patient
    • "Coughed or choked during the water drinking or had a change in voice quality after the swallow".
    • Oxygenation drops by 2% or more.

In this small study of 84 patients, this two-step test detected 96% of patients with dysphagia as compared to testing by a speech pathologist.[2]

References

  1. Anonymous (2015), Dysphagia (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 2.0 2.1 Turner-Lawrence DE, Peebles M, Price MF, Singh SJ, Asimos AW (2009). "A feasibility study of the sensitivity of emergency physician Dysphagia screening in acute stroke patients.". Ann Emerg Med 54 (3): 344-8, 348.e1. DOI:10.1016/j.annemergmed.2009.03.007. PMID 19362752. Research Blogging.