Dysphagy

The dysphagy – the complicated swallowing, is a symptom of diseases of an upper part of digestive tract and a nervous system. The dysphagy, even incidental, and especially often repeating and the more so a constant, demands the address to the doctor and carrying out careful diagnosis as diseases at which it is shown are very serious.

Dysphagy reasons

Depending on the reason causing it, the dysphagy can be:

• True;
• Functional when process does not have mechanical obstacles swallowing, and there are only frustration of a nervous system;
• Caused by organic lesions when there are diseases of an upper part of a GIT or the bodies, next to it, obstructive a food lump.

The gullet diseases creating mechanical obstacles to advance of a food lump are the most frequent reason of a dysphagy. Such state is called a gullet dysphagy. Gullet dysphagy reasons following: a gullet ulcer, an esophagitis (an inflammation of a mucous membrane of a gullet), a gullet stricture – a cicatricial posttraumatic esophageal stenosis, a gullet tumor.

Besides, diseases of the bodies, next to a gullet, at which there is its prelum can be the cause of a dysphagy. For example, hernia of esophageal department of a diaphragm, nodal craw, aortic aneurysm, mediastinum tumor, etc.

Dysphagy symptoms

The true dysphagy, disturbance actually of swallowing, that is advances of a food lump from an oral cavity in a throat, arises at defeat of the nerve centers managing the act of swallowing therefore this harmonious process is imbalanced and contents of a food lump in attempt to swallow it get not into a gullet, and into airways – a nasopharynx, a throat, a trachea. The spasm of respiratory tracts results, up to suffocation, there is severe reflex cough.

The functional dysphagy arises at functional frustration of a nervous system – a hyperexcitability, neurosises, etc. In this case symptoms of a dysphagy are shown incidentally, as a rule, them provokes any one or several types of food (firm, liquid, acute etc.). At the same time the food lump usually does not get into airways, but swallowing is complicated, and its advance on a gullet is followed by unpleasant and painful feelings.

At a gullet dysphagy the act of swallowing is not violated, but passing of a food lump is followed by pain in an upper part of a stomach, heartburn, sometimes an eructation. There is an unpleasant smack in a mouth, regurgitation – a stomach contents pelting in a throat and an oral cavity is observed. Regurgitation amplifies at inclined position of a body, and also during sleep, especially if meal was less than in two hours prior to a dream. Hoarseness of a voice, the raised slyunoobrazovaniye and suffocation can be dysphagy symptoms at an esophagitis. The gullet dysphagy is caused by firm food more often, its distinctive feature is that the zapivaniye water facilitates process, and at reception of liquid or kashitseobrazny food symptoms of a dysphagy are less expressed though the gullet dysphagy at an esophagitis can arise also at reception of liquids.

Diagnosis of a dysphagy

As the dysphagy - a disease symptom, but not an independent disease, is necessary careful diagnosis for detection of the disease which became the dysphagy reason. In the beginning conduct gastroenterological examination which main method in this case is FGDS – a fibrogastroduodenoskopiya, the endoscopic research allowing to consider a mucous membrane of an upper part of digestive tract and to reveal the available pathology. At detection of a tumor or ulcer carry out a biopsy with the subsequent histologic research, and at detection of signs of an esophagitis take gullet contents for bacteriological crops, for the purpose of identification of the activator.

If by means of gastroenterological inspection the reason of a dysphagy was not found, conduct neurologic examination, revealing the struck nervous structure.

Treatment of a dysphagy

Treatment of a dysphagy comes down to use of the local means facilitating its symptoms as the main therapeutic measures are taken in relation to that disease which served as the dysphagy reason.

Often treatment consists in acute management at emergence of acute symptoms of a dysphagy. So, in case of a true dysphagy it is necessary to clear first of all carefully airways of the food which got into them, watching that the patient did not choke. Further treatment of a dysphagy true is carried out in a hospital, in hard cases food and water are entered into a gullet through a tube.

Urgent treatment of the dysphagy caused by a gullet inflammation consists in reception of the antiacid aluminum-bearing means (reducing acidity, so-called "heartburn medicine" like Fosfalyugel, Almagelum, etc.) or reception of the sparkling tablet of Zantak dissolved in a glass of water. The subsequent treatment of a dysphagy consists in treatment of an esophagitis.

At a dysphagy of a gullet observance of certain rules of a feeding behavior and diet is necessary. So, fractional food is recommended in the small portions (not less than 4 times a day), food should not be dry and rigid, it needs to be chewed carefully. Meals hastily and with no drink are prohibited. After food it is necessary to avoid within 1,5-2 hours inclinations forward to avoid regurgitation. The last meal has to be not later, than in 2 hours prior to a dream.

If the patient has a gullet dysphagy, its diet has to consist of food, easy for digestion: low-fat grades of meat, fish and bird, and preference it is necessary to give the vegetables cooked or steamed to light meat, food fat, fried and smoked, and also acute and spicy is excluded. Fast food and all types of sparkling drinks, and also strong tea and coffee are prohibited. Alcohol is excluded completely. The rough cellulose also should be avoided. Dairy and fermented milk products are recommended, in general preference needs to be given to a milk and vegetable diet, with addition of mucous soups and porridges.