ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-based Learning (Day Two)

Pdf Summary

The document is a presentation on evaluating patients with dysphagia, which is the medical term for difficulty swallowing. Presented by Sarel Myburgh and John A. Martin from the Mayo Clinic, the lecture covers several key aspects of dysphagia: its symptoms, causes, diagnostic evaluation, and treatment options.<br /><br />The presentation outlines common symptoms associated with esophageal issues, such as gastroesophageal reflux disease (GERD), heartburn, acid regurgitation, and a sensation of food sticking in the esophagus, along with terms like odynophagia and globus. Dysphagia itself can result from mechanical blockages, dysmotility, or sensory dysfunction.<br /><br />Two polling questions are repeated focusing on the symptoms and conditions under which dysphagia becomes a medical emergency, emphasizing the seriousness when a patient cannot swallow liquids or manage secretions.<br /><br />The evaluation process includes using tools like barium swallows, endoscopy, and manometry to exclude mechanical obstructions like foreign bodies or anatomical abnormalities. When obstructive causes are ruled out, dysmotility disorders like achalasia or diffuse esophageal spasm might be considered.<br /><br />A case study of a 50-year-old female with progressive dysphagia highlights diagnostic steps, ultimately leading to a diagnosis of achalasia type II. This disorder involves abnormal esophageal muscle function, preventing normal swallowing.<br /><br />Treatment options discussed include botulinum toxin injections, pneumatic dilation, or surgical procedures like myotomy, with specific approaches depending on the subtype of achalasia diagnosed.<br /><br />In summary, diagnosing and managing dysphagia requires meticulous examination to determine whether mechanical obstructions or motility disorders are present, followed by appropriate treatment such as dilation or surgery for obstructions and medication or myotomy for dysmotility. The presentation stresses the nuanced care required in treating distinct causes of dysphagia.

Asset Subtitle

Sarel Myburgh, APRN, CNP, MS
John A. Martin, MD, FASGE

Keywords

dysphagia

swallowing difficulty

Mayo Clinic

esophageal issues

GERD

achalasia

diagnostic evaluation

treatment options

barium swallow

endoscopy