Dysphagia endoscopy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(11 intermediate revisions by 4 users not shown)
Line 2: Line 2:
{{Dysphagia}}
{{Dysphagia}}


{{CMG}}
{{CMG}}; {{AE}} {{HQ}}, {{FT}}
 
==Overview==
FEES and VFSS may be helpful in the diagnosis of dysphagia. The FEES uses a transnasal laryngoscope, and swallowing is directly evaluated by using measured quantities of food colored with blue liquid dye and compared before and after swallowing.


==Endoscopy==
==Endoscopy==
===Oropharyngeal Dysphagia===
Flexible fiberoptic endoscopic examination of swallowing (FEES)
A patient can also be assessed using [[videoendoscopy]], also known as [[flexible fiberoptic endoscopic examination of swallowing]] ([[FEES]]). The instrument, is placed into the nose until the clinician can view the [[pharynx]] and then he or she examines the pharynx and [[larynx]] before and after swallowing. During the actual swallow, the camera is blocked from viewing the anatomical structures. A rigid scope, placed into the oral cavity to view the structures of the pharynx and larynx, can also be used, however; the patient cannot swallow.
 
=== Indications ===
FEES is indicated in
* In critically ill patients.
* Patients who cannot be transferred to the fluoroscopy room.
* Patients who require prompt evaluation.


===Esophageal Dysphagia===
=== Procedure ===
[[Image:Peptic stricture.png|left|thumb|200px|[[Gastroscopy|Endoscopic]] image of peptic stricture, or narrowing of the [[esophagus]] near the junction with the [[stomach]]. This is a complication of chronic gastroesophageal reflux disease, and can be a cause of dysphagia.]]
* A scope is passed through the nasal cavity to evaluate nasopharynx, laryngopharynx, and hypopharynx.
If there is no suspicion of history of surgery for laryngeal or esophageal cancer, history of radiation or irritating injury, [[achalasia]], [[zenker's diverticulum]], endoscopy can be performed first. Any structural or mucosal abnormality is treated.
* If no structural abnormalities are seen, pharyngeal response is tested before and after swallowing.
*A normal endoscopy is followed by manometry.


A normal endoscopy should be followed by manometry; and if manometry is also normal, the diagnosis is functional dysphagia.
=== Interpretation of FEES ===
<br clear="left"/>
The endoscopy findings for dysphagia are as follows:<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><ref name="pmid2042117">{{cite journal| author=Scheurer U| title=[Dysphagia]. | journal=Ther Umsch | year= 1991 | volume= 48 | issue= 3 | pages= 150-61 | pmid=2042117 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2042117  }} </ref>
*Middle and lower biopsies of the esophagus should be taken with the intention of excluding [[eosinophilic esophagitis]].
*Majority will be normal or demonstrates only mild erosive disease.
*Structural abnormalities
**[[Strictures]]
**[[GERD]]
**Webs/Rings
[[Image:Peptic stricture.png|center|thumb|200px|[[Gastroscopy|Endoscopic]] image of peptic stricture, or narrowing of the [[esophagus]] near the junction with the [[stomach]]. This is a complication of chronic gastroesophageal reflux disease, and can be a cause of dysphagia.]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category:Needs overview]]
[[Category:Needs overview]]
[[Category:Geriatrics]]
[[Category:Geriatrics]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Otolaryngology]]
[[Category:Otolaryngology]]
[[Category:Signs and symptoms]]
[[Category:Primary care]]
{{WH}}
{{WS}}

Latest revision as of 21:30, 29 July 2020

Dysphagia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Dysphagia from other Conditions

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Barium Swallow

Endoscopy

CT

MRI

Echocardiography and Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Dysphagia endoscopy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Dysphagia endoscopy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Dysphagia endoscopy

CDC on Dysphagia endoscopy

Dysphagia endoscopy in the news

Blogs on Dysphagia endoscopy

Directions to Hospitals Treating Dysphagia

Risk calculators and risk factors for Dysphagia endoscopy

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

FEES and VFSS may be helpful in the diagnosis of dysphagia. The FEES uses a transnasal laryngoscope, and swallowing is directly evaluated by using measured quantities of food colored with blue liquid dye and compared before and after swallowing.

Endoscopy

Flexible fiberoptic endoscopic examination of swallowing (FEES)

Indications

FEES is indicated in

  • In critically ill patients.
  • Patients who cannot be transferred to the fluoroscopy room.
  • Patients who require prompt evaluation.

Procedure

  • A scope is passed through the nasal cavity to evaluate nasopharynx, laryngopharynx, and hypopharynx.
  • If no structural abnormalities are seen, pharyngeal response is tested before and after swallowing.
  • A normal endoscopy is followed by manometry.

Interpretation of FEES

The endoscopy findings for dysphagia are as follows:[1][2]

  • Middle and lower biopsies of the esophagus should be taken with the intention of excluding eosinophilic esophagitis.
  • Majority will be normal or demonstrates only mild erosive disease.
  • Structural abnormalities
Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach. This is a complication of chronic gastroesophageal reflux disease, and can be a cause of dysphagia.

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. ↑ Scheurer U (1991). "[Dysphagia]". Ther Umsch. 48 (3): 150–61. PMID 2042117.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Dysphagia_endoscopy&oldid=1637555"