Odynophagia

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Odynophagia Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Odynophagia from other Conditions

Epidemiology and Demographics

Screening

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or 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

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Synonyms and keywords: painful swallowing, pain during swallowing

Overview

Symptoms to Differentiate Odynophagia From

  • Dysphagia is defined as difficulty in swallowing

Diagnosis

History

A directed history should be performed to characterize the following:

  • Onset
  • Severity
  • Duration
  • Dysphagia with liquids versus solids
  • Psychiatric history
  • Prior episodes
  • Substance exposure
  • History of neck and head problems

Laboratory Findings

Electrolyte and Biomarker Studies

  • Creatinine phosphokinase (CPK) can be used to rule out cardiac ischemia as a cause.

Electrocardiogram

Can be used to assess for left atrial enlargement.

Chest X Ray

Can used to rule out lung cancer and other mass lesions as well as left atrial enlargement.

MRI and CT

  • MRI of brain can be used to exclude CVA and mass lesions of the head and neck.

Echocardiography or Ultrasound

Can be used to rule out an aneurysm or left atrial enlargement as a cause.

Other Diagnostic Studies

Treatment

  • Endoscopy (acute and chronic mechanical obstructions)
  • Speech therapy (ALS and stroke patients)

Pharmacotherapy

  • Proton pump inhibitors or promotility agents, weight loss, avoidance of offending foods (gastroesophageal reflux disease)
  • Anticholinergics (ALS, stroke, lower esophageal spasms)
  • Muscarinic agents (myasthenia gravis)
  • Glucocorticoids (myasthenia gravis and polymyositis)
  • Antispasmodics, botulinum toxin injection (lower esophageal spasm)

Surgery and Device Based Therapy

  • Thoracic surgery, possible balloon dilation (chronic mechanical obstruction)

References


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