Oro-Pharyngeal Dysphagia

Causes of oro-pharyngeal dysphagia

• All CNS disorders can variably affect the oral and/or pharyngeal phases of the deglutition act.

Diagnosis oro-pharyngeal dysphagia

• Videofluoroscopic recording of barium swallow.

Management oro-pharyngeal dysphagia

majority of patients:

• retraining and rehabilitative swallowing maneuvers.
   

specific groups of patients:

• percutaneous endoscopic gastrostomy; cricopharyngeal myotomy or endoscopic botulin injection
  
  
  

 Esophageal Dysphagia, HeartBurn, Regurgitation

Causes of esophageal dysphagia, heartburn, regurgitation

• All CNS disorders, more frequently in cerebral palsy, can variably induce gastro-esophageal reflux and esophagitis, and occasionally achalasic-like dysfunctions.
• Achalasia
  
  
  

Diagnosis of esophageal dysphagia, heartburn, regurgitation

• Videofluoroscopic recording of barium swallow
• Upper GI endoscopy
• pH-metry
• Manometry

Management of esophageal dysphagia, heartburn, regurgitation

• Achalasia & achalasic-like dysfunctions: pneumatic dilatation; Heller's myotomy; endoscopic botulin injection; calcium antagonists; nitrate derivates;
• GE reflux-Esophagitis: H2-antagonists; proton pump inhibitors, cisapride; domperidone; sucralfate; surgery, Nissen fundoplication