TAILIEUCHUNG - Chapter 038. Dysphagia

However, once initiated, swallowing is completed normally. Odynophagia means painful swallowing. Frequently, odynophagia and dysphagia occur together. Globus pharyngeus is the sensation of a lump lodged in the throat. However, no difficulty is encountered when swallowing is of food, resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing, is characteristic of oropharyngeal dysphagia. Phagophobia, meaning fear of swallowing, and refusal to swallow may occur in hysteria, rabies, tetanus, and pharyngeal paralysis due to fear of aspiration. Painful inflammatory lesions that cause odynophagia may also cause refusal to swallow. Some patients may feel the food as it goes. | Chapter 038. Dysphagia However once initiated swallowing is completed normally. Odynophagia means painful swallowing. Frequently odynophagia and dysphagia occur together. Globus pharyngeus is the sensation of a lump lodged in the throat. However no difficulty is encountered when swallowing is of food resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing is characteristic of oropharyngeal dysphagia. Phagophobia meaning fear of swallowing and refusal to swallow may occur in hysteria rabies tetanus and pharyngeal paralysis due to fear of aspiration. Painful inflammatory lesions that cause odynophagia may also cause refusal to swallow. Some patients may feel the food as it goes down the esophagus. This esophageal sensitivity is not associated with either food sticking or obstruction. Physiology of Swallowing The process of swallowing begins with a voluntary oral phase that includes a preparatory phase during which a food bolus suitable for swallowing is prepared and a transfer phase during which the bolus is pushed into the pharynx by contraction of the tongue. The bolus then activates oropharyngeal sensory receptors that initiate the deglutition reflex. The deglutition reflex is centrally mediated and involves a complex series of events. It serves both to propel food through the pharynx and the esophagus and to prevent its entry into the airway. When the bolus is propelled backward by the tongue the larynx moves forward and the upper esophageal sphincter UES opens. As the bolus moves into the pharynx contraction of the superior pharyngeal constrictor against the contracted soft palate initiates a peristaltic contraction that proceeds rapidly downward to move the bolus through the pharynx and the esophagus. The lower esophageal sphincter LES opens as the food enters the esophagus and remains open until the peristaltic contraction has swept the bolus into the stomach. Peristaltic contraction in response to a .

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