Triggs Joseph, Pandolfino John
Department of Medicine, Division of Gastroenterology and Hepatology, Northwestern Medicine, Northwestern University, Feinberg School of Medicine, 676 St Clair Street, Suite 14-009, Chicago, IL, 60611-2951, USA.
F1000Res. 2019 Aug 29;8. doi: 10.12688/f1000research.18900.1. eCollection 2019.
The literal definition of dysphagia is "disturbed eating". However, it is more accurately described in clinical practice as a sensation of food or liquid being stuck in the esophagus or chest. If this sensation is associated with pain, it is labeled odynophagia, and if it is associated with persistent obstruction and bolus retention, it is categorized as a food impaction. Through research and technological advances, we continue to expand our understanding of the etiologies and underlying pathophysiology relating to this complaint. However, for now, our clinical algorithms focus on endoscopy and manometry to break down dysphagia into three categories: obstructive dysphagia, esophageal motility disorders, and functional dysphagia. Here, we review some critical pitfalls in our current clinical diagnoses, new proposed underlying mechanisms of esophageal motor disorders, and developing technologies to aid in diagnosis and treatment.
吞咽困难的字面定义是“进食障碍”。然而，在临床实践中，它更准确地描述为食物或液体卡在食管或胸部的一种感觉。如果这种感觉伴有疼痛，则称为吞咽痛；如果伴有持续性梗阻和食团潴留，则归类为食物嵌塞。通过研究和技术进步，我们不断扩大对与该病症相关的病因和潜在病理生理学的理解。然而，目前我们的临床算法侧重于内镜检查和测压，以将吞咽困难分为三类：梗阻性吞咽困难、食管动力障碍和功能性吞咽困难。在此，我们回顾当前临床诊断中的一些关键陷阱、食管运动障碍新提出的潜在机制以及有助于诊断和治疗的技术发展。
