When meals are synonymous with difficulty in swallowing, pain or even a feeling of suffocation, it may be dysphagia. This swallowing disorder is not a disease in itself but a symptom that can be found in various pathologies. How to recognize and treat dysphagia? We take stock.
Dysphagia is a swallowing disorder that impairs the ability to eat and drink in people who suffer from it and which can therefore have serious consequences. It affects two million people in France and is the second leading cause of accidental death in everyday life. The the elderly are the most affected by this disorder, which is usually accompanied by pain, chest tightness or suffocation.
Dysphagia takes two different forms: oropharyngeal dysphagia and esophageal dysphagia. The first is characterized by difficulty in moving food from the oropharynx to the esophagus, while the second is characterized by difficulty in propelling food through the esophagus.
Dysphagia: what are the causes of this swallowing disorder?
Dysphagia is not a disease in itself but a symptom that can be found in various pathologies. This is the reason why a multidisciplinary collaboration involving a gastroenterologist, a neurologist, an ENT or geriatrician is useful to identify this disorder.
According to Manuel MSD, oropharyngeal dysphagia can thus have a neurological origin (stroke, Parkinson disease, multiple sclerosis…) Or muscular (myasthenia gravis, dermatomyositis, muscular dystrophy…). Esophageal dysphagia, for its part, may have its origin in motor disorders (achalasia, Chagas disease, diffuse esophageal spasms, etc.) or mechanical obstruction (stenosis, cancer of the esophagus, esophageal diaphragms, etc.).
How to diagnose dysphagia?
The diagnosis of dysphagia takes place in several stages and is primarily based on questioning the patient. The goal? That the latter describe the symptoms from which he suffers, their duration, his sensations and that he identify the foods in question but also the location of the blockage. The doctor then performs a clinical examination, during which he checks in particular the nutritional state of the person suffering from dysphagia, his muscular state, but also neurological.
The gold standard for diagnosing dysphagia is upper digestive endoscopy: it is essential to rule out cancer. To do this, a flexible tube equipped with a camera and lighting is introduced through the mouth to check for the presence of esophageal stenosis, in other words a narrowing of the esophagus. Samples biopsies are also made. If the endoscopy is normal, a manometry will be prescribed. Additional examinations as a scanner thoracic, endoscopy or a barium swallow of the esophagus can also be useful in some cases.
Dysphagia: what can be the complications of this swallowing disorder?
Dysphagia can cause complications, such as wrong way, in other words the passage of an ingested food in the airways instead of the digestive tract. This swallowing disorder can also cause pneumopathy, a undernutrition, or a dehydration.
How to treat dysphagia?
To treat dysphagia, the condition that causes it should be managed. If this swallowing disorder is due to a stenosis, for example, it may be dilated during upper gastrointestinal endoscopy.
To improve the comfort of patients suffering from dysphagia and reduce the risk of aspiration, it is possible to modify the position of the head so that it is in alignment with the body or to stimulate the muscles of swallowing. through exercises.
Sources: the manuel MSD, the French National Society of Gastro-Enterology (SNFGE) and Nutrisens.
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