n. painful swallowing. This may be due to severe inflammation of the gullet (see oesophagitis) or infection as by such as cytomegalovirus, candidiasis, or herpes simplex virus in an immunocompromised patient. Other causes include neuromuscular disease, such as *achalasia, foreign bodies, such as impacted fish bones, and malignancy.
n. difficulty in swallowing secondary to either mechanical obstruction or neurological disease. It can be caused by obstruction of the oropharynx or oesophagus by disease (for example, oesophageal carcinoma) or by neurological impairment of the coordination of the muscles involved in swallowing. Such disorders include motor neuron disease, multiple sclerosis, and stroke. A patient may describe food sticking at the level of the sternum in oesophageal dysphagia (compare odynophagia).... dysphagia
n. inflammation of the oesophagus (gullet). Frequent regurgitation of acid and peptic juices from the stomach causes reflux oesophagitis, the commonest form, which may be associated with a hiatus *hernia. The main symptoms are heartburn, acid regurgitation, *odynophagia, and sometimes difficulty in swallowing (*dysphagia). Complications include bleeding, *stricture formation, and *Barrett’s oesophagus. It is treated with antacids and by maintaining an upright position, using more pillows at night, eating the evening meal earlier in the day, weight loss, and dietary restraint. In severe cases *fundoplication surgery may be required. Corrosive oesophagitis is caused by the ingestion of caustic acid or alkali. It is often severe and may lead to perforation of the oesophagus and extensive stricture formation. Immediate treatment includes food avoidance and antibiotics; later, stricture dilatation is often needed. Infective oesophagitis is most commonly due to a fungus (Candida) infection in debilitated or immunocompromised patients, especially those being treated with antibiotics, corticosteroids, and immunosuppressant drugs, but is occasionally due to viruses (such as cytomegalovirus or herpesvirus). Eosinophilic oesophagitis is a poorly understood condition characterized by infiltration of the oesophageal lining by excess *eosinophils. Autoimmune disease and food allergy are two commonly proposed causes. Treatment is directed towards exclusion of allergens and oral or inhaled steroids.... oesophagitis
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