Drug-Induced Dysphagia

Abstract

AM Al-Shehri, Drug-Induced Dysphagia. 2003; 23(5): 249-253 Dysphagia is related to the impairment of food passage from the mouth to the stomach. It describes disability or problems in swallowing a wet or dry bolus properly. Dysphagia can be accompanied by a pain sensation in the chest, mostly caused by impaction of the food bolus in the esophagus. Dysphagia should not be confused with the globus sensation (globus hystericus), a feeling of having a lump in the throat, which is unrelated to swallowing and occurs without impaired transport.Structural lesions of the cervical spine such as diffuse idiopathic skeletal hyperostosis are rare causes of dysphagia. Dysphagia following anterior cervical fusion as well as globus and dysphonia due to dysfunction of the vertebral joints are more likely. Symptoms during swallowing of fluids indicate a neurogenic origin. Discoordinated swallowing, nasal reflux, dysphonia or general weakness may also occur.1 Chronic aspiration with respiratory compromise is the main consequence in a variety of neurological disorders as well as in cases of postsurgical dysphagia. Relaxation of the upper esophageal sphincter indicates coordinated muscle movement between the pharynx and esophagus. Dysfunction of the pharyngoesophageal segment may lead to cricopharyngeal achalasia. A dyskinetic sphincter commonly represents an extrapharyngeal cause, i.e., disease associated with gastroesophageal reflux.2 Disorders of the esophageal phase of deglutition can produce retrosternal pain, heartburn, regurgitation and vomiting, as well as laryngeal and respiratory signs. Esophageal motility disorders include lower achalasia, tumors, peptic strictures, inflammatory diseases, drug-induced ulcers, rings and webs.3 Motility disorders present with aperistaltic, spontaneous contractions, diffuse esophagospasm, or a hypermotile esophagus. Gastroesophageal reflux with esophagitis must always be excluded, especially in patients with a globus sensation. 2The diagnosis of dysphagia is based upon a careful history, clinical examination, endoscopy, dynamic imaging (videofluoroscopy, cinematography, videosonography) and electrophysiologic procedures (including pharyngoesophageal manometry, electromyography and pH determinations). 1,4 The multiple features of the appearance of the symptoms of dysphagia and globus make a multidisciplinary approach necessary to establish a diagnosis and begin effective treatment. The evaluation of a patient with symptoms of dysphagia involves two principal aspects: determining the functional level of swallowing ability and the etiology of the swallowing disorder. In long-term care facilities, patients generally present with dysphagia symptoms related to established chronic medical conditions. Whether new symptoms of swallowing dysfunction are caused by an emerging medical problem or by progression of a previously identified disease process is a secondary issue in the long-term care environment; the crucial questions relate to quality of life, requirements for daily nutrition and care, an...

Appropriateness of oral dosage form modification for aged care residents: a video-recorded observational study

“…Difficulty with swallowing medications has been reported in 15-30% of aged care residents [4,5]. This can be a result of agerelated physiological changes in their swallowing function, a sequela of different co-morbidities, or a side effect of polypharmacy [1,[6][7][8]. In addition to swallowing difficulties, other factors such as psychological aversion to taking medications or declined cognitive function may compromise older patients' ability to swallow medications safely [9].…”

Dysphagia is a Common and Serious Problem for Adults with Mental Illness: A Systematic Review

“…There is a clear need for studies evaluating the effectiveness of dysphagia interventions in this group using randomized controlled trials. (''ECT'') of (MH ''Electroconvulsive Therapy'') S24 S1 or S2 or S3 or S4 or S5 S25 S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20 or S21 or S22 S26 S24 and S25 [4] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [5] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [27] Review article [28] Commentary [29] Letter to the editor with case report [30] Study not related to dysphagia [31] Duplicate data presented in [31] which was included in the review [32] Review of another author's work. Not original article [33] Case report [34] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [35] Commentary [36] Letter to the editor [37] Letter to the editor [38] Outcomes for general population (not limited to population of interest) [39] Case report [40] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [41] Review article [42] Abstract from conference proceedings [43] Unable to locate article [44] Outcomes for general population (not limited to population of interest) [45] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [46] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [47] Letter to the editor [48] Single-case studies [49] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [50] Letter to the editor [51] Letter to the editor with single-case report [52] Commentary [53] Letter to the editor [54] Medication guideline.…”

Diagnosis and Clinical Course of Unexplained Dysphagia

“…In addition to these patients, many other patients had taken drugs that can cause xerostomia, drowsiness, and confusion. In earlier studies, these drugs are reported to possibly induce dysphagia [ 16 ], and the above-mentioned symptoms are likely to affect swallowing. However, these patients were included in the unknown group because of the relatively low correlation of these drugs with dysphagia.…”