Abstract
Swallowing disorders (dysphagia) comprise a common cause of medical consultation and
are defined as a subjective sensation of difficulty or abnormality of swallowing.
In the initial step, a clear differentiation of dysphagia from odynophagia and globus
sensation for further diagnostic procedures is mandatory. The careful questioning
of patients symptoms and complaints is often helpful for the differentiation of oropharyngeal
and esophageal dysphagia. Oropharyngeal dysphagia is mainly caused by neurological
disorders (cerebral ischemia, Parkinson’s disease, dementia) or local compression
of malignancies, thyroid gland or lymph nodes. In contrast, stenosis of the tubular
esophagus (peptic stricture, rings and webs, diverticula, malignancies, infections)
can lead to esophageal dysphagia, mostly only after ingestion of solids. Esophageal
dysphagia after ingestion of solids and liquids is often caused by motility disorders
of the esophagus (achalasia, hypertensive or hypercontractile esophagus). Important
diagnostic procedures comprise endoscopy, barium swallow and high-resolution manometry.
Overlap syndromes are frequent and need to be supervised interdisciplinary. The diagnostic
algorithm and interpretation of exam results is complex. If the results are ambiguous,
a reevaluation and, when appropriate, repetition of diagnostics are recommended. Whereas
oropharyngeal dysphagia is treated by neurologists or ENT physicians, diagnostic and
treatment of esophageal dysphagia is a challenging role for gastroenterologists.
Der Terminus „Dysphagie“ bezeichnet Schluckstörungen multipler Genese im Bereich zwischen
Lippen und Mageneingang. Eine Dysphagie kann sowohl zerebrale, degenerative, traumatische
als auch infektiöse, mechanische, funktionelle und maligne Ursachen haben – bei der
Anamnese ist insbesondere auf Alarmzeichen für ein Malignom zu achten. Dieser Beitrag
beschreibt die Dysphagie aus gastroenterologischer Perspektive.
Schlüsselwörter
Schluckstörung - Manometrie - Achalasie - Ösophaguskarzinom - neurogene Dysphagie
- Schatzki-Ring
Key words
swallowing disorders - high resolution manometry - achalasia - esophageal cancer -
Schatzki ring
