Dysphagia (synonyms: swallowing paralysis; dysphagia; swallowing paralysis; swallowing problem; Greek dys = difficult/phagein = to eat; ICD-10-GM R13.-: Dysphagia) is a swallowing disorder. If pain occurs in conjunction with the dysphagia, it is odynophagia.
Dysphagia can be divided into two main groups:
- Neurogenic dysphagia (ND) (include myopathy/muscle disease) – these occur after apoplexy (stroke) in the acute stage in approximately 50% of patients and in the chronic phase in approximately 25% of patients (most common cause of all dysphagia)
- Structural dysphagia – these occur after surgical, radiological and/or chemotherapy of head and neck tumors.
Mechanical dysphagia can be distinguished from motor dysphagia. Furthermore, dysphagia can be divided into oropharyngeal (affecting the pharyngeal area) and esophageal (affecting the esophageal area) dysphagia.
Dysphagia can be a symptom of many diseases (see under “Differential diagnoses”).
In one study, dysphagia could be classified retrospectively into five diagnostic groups:
- 55% had “nonspecific dysphagia without other signs or symptoms” (= most similar to functional dysphagia; see below).
- 17% gastroesophageal reflux disease (GERD).
- 11% neurological cause (apoplexy / stroke, dementia).
- 9 % Zenker dverticle
- 8 % other causes
The prevalence (disease frequency) for dysphagia in the general population ranges from 2.3-16%; depending on the age group, from 1.7-11.3%; in the group over 75 years of age, 45% (in Germany).
Dysphagia can occur at any age: as an acute event, as after apoplexy (stroke), or with gradual progression (progression), as in degenerative diseases.
Course and prognosis: Dysphagia always requires medical clarification. Particularly in older age, when food and fluid intake in many cases no longer meet intake recommendations, dysphagia can lead to complete food refusal, with all the subsequent problems such as weight loss and exsiccosis (dehydration).
