Dysphagia is defined as difficulty with swallowing. The vast majority of patients experiencing dysphagia will have an identifiable, organic process causing their symptoms.
The literature suggests an approach to patients with dysphagia that recognizes two broad pathophysiologic groups, patients with transfer dysphagia and patients with transport dysphagia.6 Transfer dysphagia occurs very early in the swallowing process as the food bolus moves from the oropharynx through the UES and is often reported as difficulty in initiating a swallow. In transport dysphagia, there is impaired movement of the bolus down the esophagus and through the LES. Transport dysphagia is perceived later in the swallowing process, usually 2 to 4 s or more after swallowing is initiated, and most commonly results in the feeling of food "getting stuck." This initial differentiation between transfer and transport dysphagia provides valuable information regarding the likely underlying esophageal pathology, as noted in Tâble.,Z.1:1.. Another useful classification scheme divides dysphagia into obstructive disease versus motor dysfunction. Functional or motility disorders usually cause dysphagia that is intermittent and variable. Mechanical or obstructive disease is usually progressive (solids, then liquids).
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