Download What`s the definition of dysphagia? Dysphagia is defined as a

1. What’s the definition of dysphagia?
Dysphagia is defined as a sensation of "being stuck" or the obstruction of the passage of food
through the mouth, pharynx, or esophagus. It can be described as a burning pain accompanied by
the obstruction, stuck-food or the sensation of difficulty in the passage of food down the
esophagus. Dysphagia may be due to motility disorders or to narrowing of the esophageal lumen
by benign or malignant diseases, such as inflammation or tumor of esophagus. It can also be
caused by the diseases of central nerve system.
2. Which of the following are the causes of mechanical dysphagia EXCEPT
(A) amygdalitis (B) reflux esophagitis (C) Schatzki ring (D) Myasthenia gravis (E) exceeding
enlargement of thyroid gland
KEY：(D)
3. Could you describe the classification of dysphagia in terms of its etiology?
Dysphagia could be classified into two types, one called mechanical dysphagia and the other
termed motor dysphagia.
1. Mechanical dysphagia
(1) Luminal factors: large bolus of food or foreign body
(2) Intrinsic narrowing:
1) Inflammation, pharyngitis, amygdalitis, injury to mouth and pharynx, and esophagitis.
2) Benign narrowing of esophagus: some benign tumors such as leiomyoma, angioma, and polyps;
some esophageal inflammation like reflux esophagitis, radioactive esophagitis, caustic or chemical
injury, and bacterial or fungal infection.
3) Malignant tumors: carcinoma of esophagus and cardia, sarcoma, lymphoma, etc.
4) Webs of esophagus: Plummer-Vinson syndrome
5) Esophageal mucosal ring: Schatzki ring
(3) Extrinsic compression
1) Retropharyngeal abscess or masses
2) Exceeding enlargement of thyroid gland
3) Mediastinal diseases: mediastinal tumor or abscess, left atrial enlargement, aortic aneurysm.
(4) Hiatus hernias
2. Motor dysphagia
(1) Difficulty in initiating swallowing reflex: paralysis of the tongue, oropharyngeal anesthesia,
inflammation or abscess of oropharynx, lack of saliva (e.g. Sjogren’s syndrome)
(2) Disorders of pharyngeal and esophageal striated muscle, motor neuron disease, Myasthenia
gravis, toxic diseases caused by organophosphorous insecticides or Clostridium botulinum,
polymyositis, dermatomyositis, and thyrotoxicosis.
(3) Disorders of esophageal smooth muscle: progressive systemic sclerosis, metabolic myopathy
caused by diabetes or alcoholic abuse, esophageal spasm, and achalasia, etc.