Oro-Pharyngeal Dysphagia

Causes of oro-pharyngeal dysphagia
  • All CNS disorders can variably affect the oral and/or pharyngeal phases of the deglutition act.
Diagnosis oro-pharyngeal dysphagia
  • Videofluoroscopic recording of barium swallow.
Management oro-pharyngeal dysphagia

majority of patients:

    • retraining and rehabilitative swallowing maneuvers.

specific groups of patients:

  • percutaneous endoscopic gastrostomy; cricopharyngeal myotomy or endoscopic botulin injection

 Esophageal Dysphagia, HeartBurn, Regurgitation

Causes of esophageal dysphagia, heartburn, regurgitation
  • All CNS disorders, more frequently in cerebral palsy, can variably induce gastro-esophageal reflux and esophagitis, and occasionally achalasic-like dysfunctions.
  • Achalasia

Diagnosis of esophageal dysphagia, heartburn, regurgitation
  • Videofluoroscopic recording of barium swallow
  • Upper GI endoscopy
  • pH-metry
  • Manometry
Management of esophageal dysphagia, heartburn, regurgitation
  • Achalasia & achalasic-like dysfunctions: pneumatic dilatation; Heller’s myotomy; endoscopic botulin injection; calcium antagonists; nitrate derivates;
  • GE reflux-Esophagitis: H2-antagonists; proton pump inhibitors, cisapride; domperidone; sucralfate; surgery, Nissen fundoplication