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Author: Admin | 2025-04-28
Due to some obstruction. § Cancerous growth, § B-ring § Stricture b) Dysphagia is more for both liquids and solids Neurological: It is due to mesenteric plexus, mesenteric plexus, and problem with the peristaltic movement of oesophagus. • Achalasia 2) Nature of the symptom a. Dysphagia for solids i. Intermittent • Lower oesophageal B ring ii. Progressive • Carcinoma oesophagus • Stricture of oesophagus b. Dysphagia for both liquids & solids i. Intermittent • Diffuse oesophageal spasm • Cork screw oesophagus ii. Progressive • Achalasia • Systemic sclerosis 3) Associated symptoms • Heart burn –oesophageal stricture • Weight loss • Wasting • Fatigue – suggestive of cancer • Coughing – suggests pharyngeal dysphagia due to motor dysfunction • Choking 4) Investigations Ø Barium swallow Ø Upper GI endoscopic study Ø Manometry Ø PH monitoring in the lower oesophagus Ø Lateral X ray of neck on barium swallow Some helpful findings in dysphagia • Dysphagia immediately after food: pathology in the oral cavity /pharynx. • Food regurgitated long after it was taken: oesophageal obstruction • Painful dysphagia: infective/inflammatory disorders of oral cavity, muscle contraction above the level of obstruction to the oesophagus • Painless dysphagia: tumour invasion causing denervation. • Dysphagia with dusky erythematous rash: Dermatomycositis • Dysphagia with Raynaud’s phenomenon: Systemic sclerosis • Dysphagia with cough and dyspnoea: Pulmonary aspiration Miasmatic interpretation According to the pathology and progress of the disease miasm can vary. It starts with psora, because it is functional in most of the cases. But when it comes with any obstruction, or growth, in conditions like systemic sclerosis, cancer etc. then it progress from psora to sycotic to syphilitic. So it has a trimiasmatic presentation. Dysphagia general management Ø Changing head position while eating Ø Retraining the swallowing muscles Ø Do strength and coordination exercises for tongue Ø Patients with severe dysphagia and recurrent aspiration require gastrostomy tube. Treatment § Treatment is directed at the specific cause § If a stricture, ring or web is found, careful endoscopic dilatation is performed § In achalasia balloon dilatation of the LES Homoeopathic management1) Dysphagia for solids/mechanical lesion Baptisia Constriction and contraction of oesophagus, great difficulty in swallowing solid food, painless sore throat, and offensive discharge. Contraction at cardiac orifice. Teeth and gums sore ulcerated, breath fetid, tongue feels burned. Can swallow liquid only, least solid food gags. Baryta carb Can only swallow liquids. Spasm of oesophagus as soon as
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