Dysphagia diagnostic study of choice: Difference between revisions

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== Overview ==
== Overview ==
The videofluorographic swallowing study is the gold standard for evaluating the patients presenting with dysphagia. VFSS provides information about delay in initiation of pharyngeal swallowing, nasopharyngeal regurgitation, residue of ingestate within the pharyngeal cavity after swallowing, and aspiration of ingestate.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
====Endoscopy Indications====
The endoscopy should be performed when the patient presented with symptoms of: <ref name="PhilpottGarg2017">{{cite journal|last1=Philpott|first1=Hamish|last2=Garg|first2=Mayur|last3=Tomic|first3=Dunya|last4=Balasubramanian|first4=Smrithya|last5=Sweis|first5=Rami|title=Dysphagia: Thinking outside the box|journal=World Journal of Gastroenterology|volume=23|issue=38|year=2017|pages=6942–6951|issn=1007-9327|doi=10.3748/wjg.v23.i38.6942}}</ref>
*[[Dysphagia|Difficulty swallowing]]
*[[Odynophagia|Painful swallowing]]
*When patient has risk of developing [[pneumonia]] due to [[aspiration]]


===Esophageal dysphagia===
====Endoscopy====
The endoscopy should be performed when:
*The patient presented with symptoms of difficulty swallowing, painful swallowing, and aspiration
*Standard test performed when patient has risk of developing pneumonia and diagnosing swallowing difficuties
===Video===
{{#ev:youtube|xu_YYOAlZEw}}
===Oropharyngeal dysphagia===
===Video Fluoroscopic Swallowing Study===
===Video Fluoroscopic Swallowing Study===
Video Fluoroscopic Swallowing Study(VFSS), also known as modified barium swallow, is used as the initial study for the evaluation of oropharyngeal dysphagia.<ref name="pmid17549634">{{cite journal| author=Mainie I, Tutuian R, Patel A, Castell DO| title=Regional esophageal dysfunction in scleroderma and achalasia using multichannel intraluminal impedance and manometry. | journal=Dig Dis Sci | year= 2008 | volume= 53 | issue= 1 | pages= 210-6 | pmid=17549634 | doi=10.1007/s10620-007-9845-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17549634  }} </ref><ref name="pmid23150831">{{cite journal| author=Herbella FA| title=Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later. | journal=ISRN Gastroenterol | year= 2012 | volume= 2012 | issue=  | pages= 903240 | pmid=23150831 | doi=10.5402/2012/903240 | pmc=3488400 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23150831  }} </ref><ref name="pmid11213249">{{cite journal| author=Perry L, Love CP| title=Screening for dysphagia and aspiration in acute stroke: a systematic review. | journal=Dysphagia | year= 2001 | volume= 16 | issue= 1 | pages= 7-18 | pmid=11213249 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11213249  }} </ref>
Video fluoroscopic swallowing study, also known as modified barium swallow, is used as the initial study for the evaluation of oropharyngeal dysphagia. VFSS provides the following information about the oropharyngeal swallowing mechanism:<ref name="pmid18230864">{{cite journal| author=Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA et al.| title=A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease. | journal=J Speech Lang Hear Res | year= 2008 | volume= 51 | issue= 1 | pages= 173-83 | pmid=18230864 | doi=10.1044/1092-4388(2008/013) | pmc=2894528 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18230864  }} </ref><ref name="pmid17549634">{{cite journal| author=Mainie I, Tutuian R, Patel A, Castell DO| title=Regional esophageal dysfunction in scleroderma and achalasia using multichannel intraluminal impedance and manometry. | journal=Dig Dis Sci | year= 2008 | volume= 53 | issue= 1 | pages= 210-6 | pmid=17549634 | doi=10.1007/s10620-007-9845-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17549634  }} </ref><ref name="pmid23150831">{{cite journal| author=Herbella FA| title=Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later. | journal=ISRN Gastroenterol | year= 2012 | volume= 2012 | issue=  | pages= 903240 | pmid=23150831 | doi=10.5402/2012/903240 | pmc=3488400 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23150831  }} </ref><ref name="pmid11213249">{{cite journal| author=Perry L, Love CP| title=Screening for dysphagia and aspiration in acute stroke: a systematic review. | journal=Dysphagia | year= 2001 | volume= 16 | issue= 1 | pages= 7-18 | pmid=11213249 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11213249  }} </ref>
* Delay in initiation of pharyngeal swallowing
* Nasopharyngeal regurgitation
* Residue of ingestate within the pharyngeal cavity after swallowing
* Aspiration of ingestate{{#ev:youtube|xu_YYOAlZEw}}


==References==
==References==

Latest revision as of 17:13, 23 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Feham Tariq, MD [3]

Overview

The videofluorographic swallowing study is the gold standard for evaluating the patients presenting with dysphagia. VFSS provides information about delay in initiation of pharyngeal swallowing, nasopharyngeal regurgitation, residue of ingestate within the pharyngeal cavity after swallowing, and aspiration of ingestate.

Diagnostic Study of Choice

Endoscopy Indications

The endoscopy should be performed when the patient presented with symptoms of: [1]

Video Fluoroscopic Swallowing Study

Video fluoroscopic swallowing study, also known as modified barium swallow, is used as the initial study for the evaluation of oropharyngeal dysphagia. VFSS provides the following information about the oropharyngeal swallowing mechanism:[2][3][4][5]

  • Delay in initiation of pharyngeal swallowing
  • Nasopharyngeal regurgitation
  • Residue of ingestate within the pharyngeal cavity after swallowing
  • Aspiration of ingestate{{#ev:youtube|xu_YYOAlZEw}}

References

  1. ↑ Philpott, Hamish; Garg, Mayur; Tomic, Dunya; Balasubramanian, Smrithya; Sweis, Rami (2017). "Dysphagia: Thinking outside the box". World Journal of Gastroenterology. 23 (38): 6942–6951. doi:10.3748/wjg.v23.i38.6942. ISSN 1007-9327.
  2. ↑ Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA; et al. (2008). "A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease". J Speech Lang Hear Res. 51 (1): 173–83. doi:10.1044/1092-4388(2008/013). PMC 2894528. PMID 18230864.
  3. ↑ Mainie I, Tutuian R, Patel A, Castell DO (2008). "Regional esophageal dysfunction in scleroderma and achalasia using multichannel intraluminal impedance and manometry". Dig Dis Sci. 53 (1): 210–6. doi:10.1007/s10620-007-9845-x. PMID 17549634.
  4. ↑ Herbella FA (2012). "Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later". ISRN Gastroenterol. 2012: 903240. doi:10.5402/2012/903240. PMC 3488400. PMID 23150831.
  5. ↑ Perry L, Love CP (2001). "Screening for dysphagia and aspiration in acute stroke: a systematic review". Dysphagia. 16 (1): 7–18. PMID 11213249.

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