Endoscopic Findings in Egyptian Patients with Oesophageal Dysphagia at Different Age Groups
American Journal of Internal Medicine
Volume 3, Issue 6, November 2015, Pages: 224-230
Received: Oct. 12, 2015;
Accepted: Oct. 21, 2015;
Published: Oct. 31, 2015
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Marwa Ahmed Saad Gouda, Internal Medicine Department, Geriatric Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Ahmed Ismail Al-lakani, Internal Medicine, Internal Medicine Department, Gastroenterology Unit; Faculty of Medicine, Alexandria University, Alexandria, Egypt
Magdy Mohammed Bedewy, Histo-Pathology, Pathology Department, Military Academy Hospital, Alexandria, Egypt
Dysphagia is the medical term for the symptom of difficulty in swallowing. Dysphagia can occur in all age groups, and its prevalence increases with aging. Diagnosis of dysphagia is important due to associated morbidity and mortality, so it warrants early evaluation. The current study aimed to determine the frequency of common endoscopic findings in Egyptian patients presenting with esophageal dysphagia. This cross-sectional, descriptive study was carried out in the department of Gastroenterology, faculty of medicine, Alexandria University in the period from January 2012 -December 2014. 127 patients with dysphagia were included in the study and were subjected to endoscopy. A total of 127 patients; 73 females (57.5%), and 54 males (42.5%) presenting with dysphagia were studied, the mean age was 49.56±16.41 years. gastro-esophageal reflux (GERD)/reflux esophagitis was the most common findings noted in 25(19.7%) patients, followed by esophageal stricture noted in 22 patients (17.3%), esophageal mass in 21 patients (16.5%), normal endoscopic findings in 20 patients (15.7%), achalasia of the esophagus in 12 patients (9.4%), eosinophilic esophagitis in 6 (4.7%) patients, esophageal web/rings in 5 (3.9%)patients, diffuse esophageal spasm in 4 patients ( 3.1%), foreign body impaction in 2 patients (1.6%), and hiatal hernia in 2 patients (1.6). 8 (6.3%) patients had findings other than the ones mentioned above. We concluded that GERD/reflux esophagitis, and esophageal strictures are the commonest causes of dysphagia in our population. Also malignant esophageal mass is the main cause of dysphagia in elderly population, both warrants early diagnosis and management.
Marwa Ahmed Saad Gouda,
Ahmed Ismail Al-lakani,
Magdy Mohammed Bedewy,
Endoscopic Findings in Egyptian Patients with Oesophageal Dysphagia at Different Age Groups, American Journal of Internal Medicine.
Vol. 3, No. 6,
2015, pp. 224-230.
Brady A. "Managing the patient with dysphagia". Home Healthc Nurse 2008; 26 (1): 41–6; quiz 47–8.
Sleisenger, Marvin H.; Feldman, Mark; Friedman, Lawrence M. Sleisenger & Fordtran's Gastrointestinal & Liver Disease 2002; 7th edition. Philadelphia, PA: W.B. Saunders Company. Chapter 6, p. 63.
Logemann, Jeri A. Evaluation and treatment of swallowing disorders. Austin, Tex: Pro-Ed.1998; ISBN 0-89079-728-5.
Locke GR, 3rd, Talley NJ, Fett SL, et al. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997; 112: 1448–56.
Eslick GD, Talley NJ. Dysphagia: epidemiology, risk factors and impact on quality of life--a population-based study. Aliment Pharmacol Ther 2008;27:971–9.
Martino R, Foley N, Bhogal S, et al. "Dysphagia after stroke: incidence, diagnosis, and pulmonary complications" Stroke 2005; 36 (12): 2756–63.
Mann G, Hankey GJ, Cameron D. Swallowing function after stroke: prognosis and prognostic factors at 6 months. Stroke 1999; 30: 744–8.
Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am 2008; 19:853–66.
Shaker R, Staff D. Esophageal disorders in the elderly. Gastroenterol Clin North Am 2001;30(2):335-61.
Longo DL, Fauci AS, Kasper DL,et al. Harrison’s Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2011. pp. Chapter 38–Dysphagia.
Lew RJ, Kochman ML. A review of endoscopic methods of esophageal dilation. J Clin Gastroenterol 2002; 35:117-26.
Ahtaridis G, Snape WJ, Cohen S. Clinical and manometric findings in benign peptic strictures of the esophagus. Dig Dis Sci 1979 Nov. 24(11):858-61.
Montgomery, EA et al. "Oesophageal Cancer". In Stewart, BW; Wild, CP. World Cancer Report 2014. World Health Organization. pp. 528–43.
De Jonge, PJ; van Blankenstein, M; Grady,et al. "Barrett's oesophagus: epidemiology, cancer risk and implications for management" Gut 2014; 63 (1): 191–202.
Park W, Vaezi M. "Etiology and pathogenesis of achalasia: the current understanding". Am J Gastroenterol 2005; 100 (6): 1404–14.
Chuah, SK; Hsu, PI; Wu, KL; et al. "2011 update on esophageal achalasia." (PDF). World journal of gastroenterology: WJG 18 (14): 1573–8.
Schatzki R, Gary JE. Dysphagia due to a diaphragm-like localized narrowing in the lower esophagus ("lower esophageal ring"). Am J Roentgenol 1953; 70:911-22.
Smout AJ. Advances in esophageal motor disorders. Curr Opin Gastroenterol 2008 Jul. 24(4):485-9.
Blanchard C, Rothenberg ME. "Basic pathogenesis of eosinophilic esophagitis". Gastrointest. Endosc. Clin. N. Am 2008; 18 (1): 133–43.
Palmer KR, Penman ID. Alimentary tract and pancreatic diseases. In: Colledge NR, Walker BR, Ralston SH, editors.Davidson’s principles and practice of medicine. 21st edition. Edinburgh: Churchill Livingstone. 2010: p850.
Majeski J, Lynch W, Durst G. Esophageal perforation during esophagogastroduodenoscopy. Am J Surg 2009; 198:56-7.
Wilkins T, Gillies RA, Thomas AM,et al. The prevalence of dysphagia in primary care patients: a Hames Net Research Network study. J Am Board Fam Med.2007; 20:144–50.
Sura L, Madhavan A, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 2012; 7:287-98.
Fucile S, Wright PM, Chan I, et al. Functional oral-motor skills: Do they change with age? Dysphagia 1998;13:195–201.
Drossman D, editor. Rome III: The Functional Gastrointestinal Disorders. 3rd ed. McLean, VA: Degnon Associates, Inc; 2006.
Satti SA, Ahmed SI, Habib M, et al. Flexible Oesophagoscopy in oesophageal dysphagia: A 134 Patient Series. J Rawal Med Coll 2002;6(1):26–9.
Krishnamurthy C, Hilden K, Peterson KA, et al. Endoscopic findings in patients presenting with dysphagia: analysis of a national endoscopy database. Dysphagia 2012; 27:101–5.
Khan AN, Said Kh, Ahmad M, et al. Endoscopic findings in patients with esophageal dysphagia. J Ayub Med Coll Abbottabad 2014; 26(2):216–20.
Kumbum K, Julian K, Maurice A Cerulli,et al. Esophageal Stricture. Medscape reference. Updated: Dec 16, 2014.
Gilani N, Stipho S, Shaukat MS, et al. The yield and safety of string capsule endoscopy in patients with dysphagia. Gastrointest Endosc. 2007; 66:1091–5.
Allaix ME, Patti MG. Achalasia. Medscape reference. Updated: Nov 06, 2014.
Moawad FJ, Dellon ES, Achem SR,et al. Effects of Race and Sex on Features of Eosinophilic Esophagitis. Clin Gastroenterol Hepatol 2015 Sep 3. pii: S1542-3565(15)01193-3.
Veerappan GR1, Perry JL, Duncan TJ, et al. Prevalence of eosinophilic esophagitis in an adult population undergoing upper endoscopy: a prospective study. Clin Gastroenterol Hepatol. 2009 Apr; 7(4):420-6, 426.e1-2.
Zervos X, Pyrsopoulos. Esophageal Webs and Rings. Medscape reference. Updated: Jul 24, 2015.