Symptoms, Diagnosis and Treatment of Esophagus Dysphagia

A phenomenon in which a person experiences discomfort when swallowing or can not swallow anything (food, water, saliva) is called dysphagia. A single manifestation of this condition can alert a person, and if such a phenomenon has been observed many times, then it is necessary to consult a doctor and treat dysphagia.

Do not confuse the true dysphagia and pseudodiffusion. At the last in the area of the esophagus or behind the breast bone, a "lump" is felt, and the swallowing process remains normal. The phenomenon of dysphagia often accompanies reversible mental disorders, accompanied by violent emotional reactions (loud laughter, tears, crying), turbidity, convulsions, as well as diseases of the thyroid and heart.

Symptoms of dysphagia of the esophagus

The treatment will be discussed in more detail below. In the meantime, we will describe the symptoms of this disease.

The violation of the lump of food from the oral cavity into the esophagus or, as we have already called this phenomenon, the true dysphagia, arises from the defeat of the nerve centers that control the swallowing process, which leads to an imbalance of this complex process. As a result, when you try to swallow a food lump, its contents enter the respiratory tract (nasopharynx, larynx, trachea) and not into the esophagus. This causes a spasm of the respiratory tract, suffocation and a strong reflex cough.

Nervous system disorders, such as increased excitability or neurosis, can cause functional dysphagia. Symptoms of it appear episodically, patients associate them with the reception of a certain type of food (for example, hard, sharp, liquid and so on). The food does not enter the respiratory tract, but the swallowing process is difficult, and the advance along the esophagus is associated with painful and unpleasant sensations. Treatment of dysphagia should be comprehensive.

Causes of dysphagia

The process of swallowing can be divided into 3 phases:

• Oral (arbitrary), when a person controls a sip independently;
• Pharyngeal (rapid involuntary), when an uncontrolled person swallows quickly;
• Esophageal (slow involuntary) with slow uncontrolled movement along the esophagus of food.

With nervous dysphagia treatment is aimed at correcting the human psyche. The act of swallowing food in the dysphagia of the esophagus is not disturbed, but advancing over it causes pain at the top of the abdomen, heartburn, belching. Also there is regurgitation, when the contents of the stomach are thrown into the pharynx and mouth, causing an unpleasant taste in the mouth. Increased regurgitation can occur with an inclined position of the body, including during sleep, if the dinner was less than two hours before night rest.

Dysphagia can be accompanied by symptoms such as hoarseness, high salivation and suffocation. Most often, dysphagia of the esophagus is provoked by solid food. Patients note that when drinking with water or taking a pungent or liquid food, it becomes easier to swallow. Although there are cases when liquid food caused dysphagia, symptoms and treatment are of paramount importance.

Forms of the disease

Depending on the place of the process, the following forms of dysphagia are distinguished:

• Oropharyngeal (it is difficult to promote food into the esophagus, an arbitrary phase of swallowing is disturbed);
• Gullet-esophageal (food intake in the esophagus is complicated, fast involuntary swallowing phase is disrupted);
• Esophageal (the passage through the esophagus of food is complicated, the slow involuntary phase of swallowing is disturbed).

Dysphagia is also divided into:

• Organic (the cause of its occurrence are the pathologies of the upper gastrointestinal tract);
• Functional. It is observed in the case of a CNS disorder, provided that there are no mechanical barriers to passage of food.

Treatment of functional dysphagia is performed by a doctor-psychotherapist or neurologist along with a gastroenterologist.

Causes of a pathological condition

Often the development of dysphagia is a symptom of diseases of the esophagus. They include:

• Esophagitis - inflammation of the mucosa of the esophagus.
• Gastroesophageal reflux disease (GERD). With this disease, the contents of the stomach splash into the esophagus, irritating its walls.
• Exertion of the walls of the esophagus (diverticula).
• Cicatricial narrowing of the esophagus, which arose after healing of chemical burns, caused by intake of acid or alkali. After a similar effect, the elastic tissue of the esophagus is replaced by a connective, poorly stretched and not conducive to food through the esophagus.
• Malignant tumors of the esophagus and stomach. As a rule, these are fast-growing, sprouting tumors to neighboring organs.
• Achalasia of the cardia. The passage of the food lump from the esophagus to the stomach is broken, the reason lies in the chronic neuromuscular disease of the esophagus.

Also, dysphagia can develop against the background of:

• Violations of the outflow of venous blood from the liver (portal hypertension), esophageal veins and liver failure (the liver ceases to perform its functions due to acute or chronic process of destruction of its cells);
• Injury of the esophagus (damage from the inside of the esophagus, for example, if swallowed by an acute object, knife or bullet wound of the chest, etc.);
• External narrowing of the esophagus, which can be caused by aortic aneurysm (enlargement of the aorta), an increase in the heart, a tumor of the mediastinum - the thoracic region, left and right limited by the lungs, in front of the sternum, and behind the vertebral column. It is the esophagus, the trachea, the heart and thymus gland (the organ of the immune system).

Treatment of dysphagia after a stroke is often required.

Dysphagia can also cause pathological lesions of the oropharynx:

• tumor;
• Quincke's edema (severe allergic reaction with development of extensive laryngeal and pharyngeal edema);
• Angina (inflammation of the tonsils);
• Foreign bodies (bones, pieces of food, etc.);
• Paralysis of pharyngeal muscles. It occurs, as a rule, after violations of cerebral circulation (stroke), developing against the background of atherosclerosis (clogging the cerebral vessels with atherosclerotic plaques). It can be a consequence of a brain tumor, as well as an injury to the cervical spine. All this causes dysphagia of the esophagus. Treatment and its success depend on correct diagnosis.

Methods of diagnosis

Diagnosis of the disease includes the following activities:

• The collection of complaints and anamnesis of the disease with the following information: the timing of the onset of symptoms, whether the swallowing is disturbed all the time, whether it is painful when swallowing, whether there is a feeling of discomfort behind the breastbone during a meal, with which the patient associates their occurrence, whether difficulties arise when swallowing only hard food, And now it's liquid or something else.
• The analysis of the anamnesis of life: what diseases the patient suffered, whether there were operations, burns of the esophagus, inflammation of the stomach (gastritis), gastrointestinal diseases.
• Analysis of the hereditary history (whether the closest relatives of the disease of the gastrointestinal tract, in particular, the disease of the esophagus).
• Inspection of the patient, a thorough examination of the oral cavity, palpation of the lymph nodes of the neck to identify the syndrome of dysphagia. Diagnosis and treatment of this disease should be timely.
• General and biochemical blood tests - to determine the level of hemoglobin (oxygen-carrying protein), erythrocytes, leukocytes (their increase indicates the presence of an inflammatory process), as well as control of the kidneys, pancreas and liver.
• Coprogram - microscopic analysis of feces (the study reveals undigested food fragments, coarse dietary fibers, fat).
• Laryngoscopy: visual inspection of the back of the throat is performed using an endoscope.
• Esophagogastroduodenoscopy (EHDS) - examination with the aid of the gastrointestinal apparatus of the duodenum, stomach and esophagus, with this study it is possible to take a piece of mucosa for biopsy.
• Ultrasound examination (ultrasound). It allows to assess the condition of the abdominal cavity organs (intestine, gallbladder, kidneys, bile ducts, stomach, pancreas) and to find out possible causes of dysphagia.
• X-ray examination of the esophagus. It also makes it possible to identify some diseases or conditions that could lead to difficulty swallowing.
• Irrigoscopy is an x-ray examination of the esophagus with the introduction of a contrast agent, clearly manifested in the picture. It allows to detect narrowing or obstruction of substances along the esophagus.
• MRI (magnetic resonance imaging) of the brain and brain electroencephalography are performed to detect the pathology of the nervous system, if no mechanical obstruction was found during examination of the patient with dysphagia, which prevents the food lump from moving through the esophagus and oropharynx.

A patient with problems with swallowing is required to get a consultation of doctors: an otolaryngologist, a neurologist, a gastroenterologist.

Drug treatment for dysphagia

Drug therapy (with the help of medications) is to take medication. Most often, inhibitors that reduce the acidity of stomach contents are prescribed if this is the cause of dysphagia. Also, antibacterial therapy of inflammatory processes of the pharynx and esophagus, which led to a violation of swallowing, will be required. Drugs for the treatment of dysphagia should appoint a doctor.

Surgery

It is necessary to remove the effects of burns of the esophagus, which caused its constriction, inflammation, and tumors. There are no other ways to eliminate these obstacles that interfere with the swallowing process.

If the patient's condition during the recovery from a stroke does not allow surgical treatment to eliminate the cause of dysphagia (for example, in a tumor of the esophagus), then temporary interventions are made to facilitate the patient's well-being.

Is it possible for dysphagia to be treated with folk remedies? About this further.

Traditional methods of treatment

Cure with unpleasant symptoms for dysphagia will help phytotherapy. Before eating, drink a decoction of herbs, which has a calming effect:

• Cones of hops - 25 g.
• Leaves peppermint - 25 g.
• Rosemary leaves - 20 g.
• The root of valerian is 30 g.
• St. John's wort - 20 g.
• Leaves of lemon balm - 25 g.

The collection should be thoroughly mixed, scooped 1 tablespoon and pour 1 cup of boiling water, insist for two hours. Then the infusion is required to strain. Take a quarter cup three times a day for half an hour before meals.

An antispasmodic property is the tincture of the belladonna (belladonna). It is required to take 5 drops three times a day for 5 minutes before meals.

There is another healing agent with similar properties:

• Root and rhizome broad-leaved, 15 g.
• Ephedra herb, 20 g.
• Herb of the motherwort, 20 g.

The shredded collection is poured with a liter of cold water for four hours, then boil for two minutes, cool, filter. Two tablespoons of the obtained composition should be taken ten minutes before meals.

With dysphagia, folk treatment does not always help, so specialist advice is mandatory.

What does the diet include?

Treatment of dysphagia is complex, therefore, in order to facilitate physical condition, certain rules of nutrition must be observed.

• Fractional food intake in small portions.
• Thorough grinding or chewing food.
• Increase the amount of fluid consumed.
• Refusal of dishes irritating the esophagus mucous (acute, salty, spicy, too cold or hot), eating dry, strong coffee and tea, fizzy drinks and alcohol.

You may need to conduct bougie - a multiple expansion of the lumen of the esophagus by a bougie, a special expander. This is the treatment of dysphagia.

Consequences and complications

• Persistent respiratory failure, sometimes to its full stop, caused by a tumor of the esophagus, compressing the trachea (an organ that conducts air into the lungs).
• Inflammation of the esophagus (esophagitis).
• Malignant tumors (rapidly growing and spreading throughout the body) of the esophagus or the initial part of the stomach.
• Aspiration pneumonia, when in violation of the swallowing function, the contents of the oropharynx are thrown through the nose into the lungs and the trachea, and on the way out there is the development of pneumonia, pneumonia.
• Abscesses of the lungs (surrounded by a protective capsule of abscesses) that occur when the contents of the stomach are thrown into the respiratory tract and promote the development of inflammation.
• Pneumosclerosis, which is a violation of the structure of lung tissue due to its damage to the contents of the stomach (it is acidic), which got there after casting due to impaired swallowing.
• Decreased body weight due to the small number of incoming nutrients.
• Loss of body water or dehydration.

We considered such a disease as dysphagia. Diagnosis, symptoms, treatment are described in detail in this article.