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Definition: dysphagia from The Penguin Dictionary of Psychology

An umbrella term for any abnormal eating pattern. Some authors restrict its application to eating disorders caused by neurological dysfunctions, others use it more generally. For specific forms see APHAGIA, BULIMIA, HYPERPHAGIA and PICA.


Summary Article: Dysphagia
from Encyclopedia of Global Health

Dysphagia is a condition of having difficulty swallowing. Two classifications exist: transfer dysphagia and esophageal dysphagia. Both are characterized by the complaints that foods and liquids are slow to go down and cling to the throat. Both can be either sporadic or chronic in nature. Additionally, both have certain triggers that help classify the disorder.

Transfer dysphagia is caused by disorders often stemming from strokes or neurological complications. In this case, a disruption of the motor sensors and controls prevents a patient from being able to trigger the swallowing mechanisms in an automatic fashion. The life span of transfer dysphagia is affected by what the underlying cause is. Patients who have had a stroke often experience weakness of one side of the mouth that makes the swallowing process difficult. This weakness, however, can be mediated with time and practice. Some neurological disorders, however, have a bleaker outcome and the life of the patient may be riddled with bouts of dysphagia.

Regardless of the underlying cause of transfer dysphagia, it is characterized as being triggered by the swallowing process rather than a certain type of food. Because the problem is with the swallowing action, a major concern for transfer dysphagia patients is that food or drink will enter the lungs or chest cavity, cause choking, or be expelled from the nose.

Unlike transfer dysphagia, esophageal dysphagia is typically caused by structural disorders in the throat. Tumors and lesions in the throat are very common to the esophageal dysphagia patient. The defining aspect between transfer dysphagia and esophageal dysphagia is that esophageal dysphagia is linked directly to food and not the act of starting to swallow. In esophageal dysphagia, the act of swallowing can be initiated with success, but the food or drink may be slow to go down the throat, or may cause a clinging sensation—a feeling that the food is clinging to the throat.

Esophageal dysphagia can be long lasting or may occur only a few times without a noticeable pattern. With that, esophageal dysphagia can start out weak and progress in severity, or start out in a very severe fashion and ease with time. The major factors at work in either case are the underlying conditions that are causing the esophageal dysphagia. Structural disorders such as a tumor may be slow to grow and will not block as much food as would occur in the later stages of growth. Conversely, a heavy impact to the throat or muscles surrounding the throat may cause a sudden challenge to swallowing, one that will soften with time.

Regardless of the cause, patients with esophageal dysphagia often experience comfort with regurgitation of the food. Regurgitation is typically better tolerated than trying to force the food to swallow, which may cause some additional discomfort. Complaints such as heartburn, sore throat, chest pain, and coughing up food are common to the esophageal dysphagia patient. Both transfer dysphagia and esophageal dysphagia are defined as difficulty swallowing. Transfer dysphagia is characterized by the physical act of initiating the swallow, while esophageal dysphagia is characterized by the food or drink not going down correctly.

    SEE ALSO:
  • Bell’s Palsy; Cancer (General); Food Allergy.

BIBLIOGRAPHY
  • Elayne Achilles, The Dysphagia Cookbook: Great Tasting and Butritious Recipes for People with Swallowing Difficulties (Cumberland House, 2003).
  • Lynn S. Bickley, ed., Bates’ Guide to Physical Examination and History Taking, 8th ed. (Lippincott Williams and Wilkins, 2003).
  • William J. Hamilton
    Arizona State University
    Copyright © 2008 by SAGE Publications, Inc.

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