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Dysphagia

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Geriatric Gastroenterology

Abstract

Dysphagia in an older adult should always lead to a prompt and definitive evaluation. Thirty to fifty percentage of nursing home residents have dysphagia. The prognosis of dysphagia is worse in the old. Dysphagia may be the first symptom of a systemic disorder. Oropharyngeal (or transfer) dysphagia (OPD) and esophageal dysphagia can result from inflammatory, mechanical, or functional causes. All forms of dysphagia are often referred to the suprasternal notch or neck. Concurrent neurologic symptoms, nasopharyngeal regurgitation, dysphonia, drooling, aspiration, and coughing after eating suggest OPD. Dysphagia localized below the sternum, chronic GERD, caustic ingestion, or immunocompromised states suggests esophageal dysphagia. Nearly half the patients with dysphagia have non-obstructive dysphagia related to acid reflux-induced esophagitis. Because inflammation is the most common cause of dysphagia endoscopy with biopsy should be performed in all patients. Eosinophilic esophagitis, the most common cause of food impaction, has been diagnosed for the first time in octogenarians. Esophageal cancer invariably leads to dysphagia. Esophageal adenocarcinoma exceeds the incidence of squamous cell cancer in all age groups. Fortunately, benign mechanical causes are three times more common than malignant obstruction.

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Authors and Affiliations

  1. Department of Medicine, Drexel University College of Medicine/Hahnemann University Hospital, 245 North 15th Street, Mail Stop 487, Philadelphia, PA, 19102-1192, USA

    James C. Reynolds MD

  2. Department of Internal Medicine, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA

    Bassem R. George MD

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  1. James C. Reynolds MD
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  2. Bassem R. George MD
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Correspondence to James C. Reynolds MD .

Editor information

Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

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Reynolds, J.C., George, B.R. (2012). Dysphagia. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_29

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  • DOI: https://doi.org/10.1007/978-1-4419-1623-5_29

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1622-8

  • Online ISBN: 978-1-4419-1623-5

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