Saturday, May 27, 2023

Pt. Presented after insertion of complete denture complaining of dysphagia and ulcers what is the cause of dysphagia.. over extended



Pt. Presented after insertion of complete denture complaining of dysphagia and ulcers what is the cause of dysphagia?

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What is dysphagia?

Dysphagia is the medical condition that causes difficulty or absolute impossibility when swallowing solid and liquid foods. When dysphagia exists, the swallowing process becomes very difficult and complicated, and can even force serious patients to look for alternative ways to maintain basic nutrition.

Types of dysphagia:

As for the types of dysphagia, there are two depending on where we find the difficulty in swallowing:
- The oropharyngeal dysphagia is the one that originates in the area of ​​the pharynx, making it difficult to pass solid and liquid foods from the first moment of the swallowing process. Severe cases could suffer from constant aspiration with what food would pass into the trachea, choking the patient.
- The second type is esophageal dysphagia. In this case, the swallowing process manages to take solid and liquid food beyond the pharynx, but difficulties appear as they go down the esophagus. In severe cases, there may be constant vomiting that completely precludes nutrition.

Causes of dysphagia:

The causes behind a case of dysphagia can be very varied. It is convenient to keep in mind that about 50 pairs of muscles and nerves are necessary to swallow food. In addition, dysphagia could result from a more serious existing disease.

Causes oropharyngeal dysphagia:

In the case of oropharyngeal dysphagia, the following causes are usually managed:
  • Diseases that directly affect the pharynx or oral cavity, such as pharyngitis, tonsillitis and candidiasis.
  • Pharyngeal diverticulum, in this case a pouch is formed on the esophagus, collecting solid food particles that in the short term begin to create difficulties in swallowing, including also coughing attacks, bad breath and regurgitation of food.
  • Neurological conditions of multiple types, from Parkinson's disease and multiple sclerosis to strokes and injuries.
  • Cancer and tumors in the area of ​​the pharynx.
  • Radiation therapy to treat tumors, treatment that could inflame the tissues of the area.

Causes esophageal dysphagia:

As for esophageal dysphagia, the causes are usually much more varied than in the previous case. These include:
  • Diaphragmatic hernia, also known as hiatus or hiatal hernia.
  • Different conditions that directly affect or are related to the esophagus, such as achalasia, esophageal spasms, gastroesophageal reflux, stenosis, eosinophilic esophagitis and scleroderma.
  • Inadequate function of the esophageal ring.
  • Cancer and tumors in the area of ​​the stomach and esophagus.
  • Radiation therapy to treat tumors, being a treatment that can cause inflammation, scarring and stricture of the esophagus.

Symptoms of dysgafia:

In addition to the most representative symptom that dysphagia has, which is the difficulty in swallowing solid and liquid foods, there are other types of symptoms that may be very present.
In cases of oropharyngeal dysphagia, there is a chance of coughing and suffocation during meals. On the other hand, patients with esophageal dysphagia experience severe heartburn and vomiting of what is being swallowed. Outside of the meal, some symptoms of dysphagia are heartburn, weight loss, regurgitation, drooling and hoarseness when sleeping.

Diaphagia in children:

Dysphagia in children presents a series of signs to which we must pay attention, since a young child cannot explain the difficulty of swallowing food, parents should be aware of the following symptoms:
  • Rejection of solid foods.
  • Body tension during the time of eating.
  • Cough, vomiting and difficulty breathing during the time of eating.
  • Weightloss.

Diagnosis of dysphagia:

Due to the wide variety of causes behind a dysphagia, the specialist will have to do a thorough job to diagnose the problem. Even when it is a mild case of this disease, there must be a willingness to know why it is happening and what is the most effective treatment to avoid more serious medical conditions, not only for the disease itself, but for the possible consequences that these can carry.

Initially, the ENT will gather information about when and how that difficulty swallowing happens, as well as what foods cause the patient the most problems. Then you will observe the mouth and pharynx while the patient chews and swallows.

If necessary, the ENT will perform a more precise instrumental examination to make the diagnosis such as X-rays, endoscopy and manometry. During X-rays, the patient should ingest a harmless solution of barium, which will allow to see the movement of the fluids inside the pharynx and esophagus, as well as possible obstructions.

Dysphagia treatment:

When it comes to dysphagia, treatment should always aim first to prevent it from getting worse. Once this is achieved, the original cause is treated and important improvements are sought until the symptoms cease and the problem of evidence of having disappeared.

When an infection dysphagia is diagnosed, the course of action is the controlled use of antibiotics. In cases where dysphagia is a consequence of neurological problems, motor therapy is usually the most efficient resource to allow the patient to overcome it.

The existence of esophageal dysphagia may require medications to reduce heartburn and reflux, treating this gastric condition to prevent stomach rejection of solid and liquid foods consumed.

Also, doctors usually treat cases of achalasia and esophageal stricture with manual dilation. To achieve this, a suitable endoscope is used with a balloon that widens the esophagus.

Whatever the dysphagia type, cases of cancer and tumors are only treatable with surgery. If the dysphagia has reached a very severe state, the doctor may be forced to use a feeding tube through the abdomen to allow the patient adequate nutrition.