Division of Gastroenterology, Washington University School of Medicine, Campus Box 8124, 660 South Euclid Avenue, St Louis, MO 63110, USA.
United Health Services Hospitals, Johnson City, NY, USA.
Prim Care. 2023 Sep;50(3):325-338. doi: 10.1016/j.pop.2023.03.001. Epub 2023 May 22.
Dysphagia is an important clinical symptom that increases in prevalence with age. Both oropharyngeal and esophageal processes can contribute to dysphagia, and these can be differentiated with a careful history. Neuromuscular processes are more prevalent than structural causes in oropharyngeal dysphagia, therefore, investigation should start with a modified barium swallow. In contrast, structural processes dominate in esophageal dysphagia, and endoscopy can offer biopsy and therapy by way of dilation. Manometry is performed for esophageal dysphagia when no structural etiology is found. Specific management of dysphagia is dependent on the etiology and mechanism of dysphagia.
吞咽困难是一种重要的临床症状，随着年龄的增长而愈发普遍。口咽和食管过程均可导致吞咽困难，通过仔细的病史可进行区分。神经肌肉过程比口咽吞咽困难的结构原因更为普遍，因此，检查应从改良钡餐开始。相比之下，结构过程在食管吞咽困难中占主导地位，内镜检查可提供活检和扩张治疗。当未发现结构病因时，进行测压法以诊断食管吞咽困难。吞咽困难的具体治疗取决于吞咽困难的病因和机制。
