Oro-Pharyngeal Dysphagia
Causes of oro-pharyngeal dysphagia
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All CNS disorders can variably affect the oral and/or pharyngeal phases of the deglutition act.
Diagnosis oro-pharyngeal dysphagia
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Videofluoroscopic recording of barium swallow.
Management oro-pharyngeal dysphagia
majority of patients:
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retraining and rehabilitative swallowing maneuvers.
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specific groups of patients:
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percutaneous endoscopic gastrostomy; cricopharyngeal myotomy or endoscopic botulin injection
Esophageal Dysphagia, HeartBurn, Regurgitation
Causes of esophageal dysphagia, heartburn, regurgitation
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All CNS disorders, more frequently in cerebral palsy, can variably induce gastro-esophageal reflux and esophagitis, and occasionally achalasic-like dysfunctions.
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Achalasia
Diagnosis of esophageal dysphagia, heartburn, regurgitation
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Videofluoroscopic recording of barium swallow
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Upper GI endoscopy
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pH-metry
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Manometry
Management of esophageal dysphagia, heartburn, regurgitation
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Achalasia & achalasic-like dysfunctions: pneumatic dilatation; Heller’s myotomy; endoscopic botulin injection; calcium antagonists; nitrate derivates;
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GE reflux-Esophagitis: H2-antagonists; proton pump inhibitors, cisapride; domperidone; sucralfate; surgery, Nissen fundoplication