Dysphagia and Its Management

Dysphagia, generally referring to difficulty in swallowing, occurs when an individual experiences obstruction during the swallowing process, resulting in a subjective sensation of blockage or stagnation in the esophageal region. This condition demands prompt attention as it may be indicative of an underlying organic pathology.

In such cases, it is crucial to seek immediate medical attention and undergo comprehensive examinations to identify the specific cause of dysphagia, whether it is related to the esophagus, throat, or other anatomical structures, and whether it is due to obstruction, tumor, or other factors.

Management of Dysphagia

For patients experiencing dysphagia, the foremost step is to consult a doctor as soon as possible, either in the gastroenterology or thoracic surgery department. Relevant examinations such as chest CT, endoscopy, and esophageal barium swallow radiography are conducted to establish a clear diagnosis and formulate a targeted treatment plan.

If dysphagia is caused by esophageal cancer, surgical intervention is the primary treatment option if operable. If surgery is not feasible, radiotherapy or chemotherapy may be considered. If esophageal barium swallow radiography suggests achalasia, minimally invasive endoscopic procedures may be performed. If endoscopy reveals dysphagia due to esophageal reflux, proton pump inhibitors are typically prescribed to reduce acid secretion.

If all the above-mentioned examinations are normal, dysphagia may be attributed to psychological factors such as anxiety or depression, and appropriate psychological interventions should be implemented.

Causes of Dysphagia

1. Oral and Pharyngeal Diseases: Including pharyngitis, oral and pharyngeal trauma, diphtheria, pharyngeal tuberculosis, pharyngeal tumors, and posterior pharyngeal abscess.

2. Esophageal Diseases: Such as esophagitis, benign esophageal tumors, esophageal cancer, esophageal foreign bodies, esophageal motility disorders (e.g., achalasia, diffuse esophageal spasms), and extreme thyroid enlargement. Among these, esophageal cancer is a significant cause.

3. Neuromuscular Diseases: Including bulbar paralysis, myasthenia gravis, organophosphorus pesticide poisoning, polymyositis, dermatomyositis, and cricopharyngeal achalasia.

4. Systemic Diseases: Such as rabies, tetanus, botulism, and iron-deficiency dysphagia (Plummer-Vinson syndrome).

Oral and Pharyngeal Diseases

Diseases of the throat and pharynx, including tuberculous or neoplastic lesions (including malignant granulomas) and posterior pharyngeal abscess, can cause swallowing disorders. In most cases, after receiving specialized and targeted treatment, the sensation of swallowing obstruction can be improved or resolved.