Deglutition Disorders (Dysphagia)

Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.

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Networked: 4413 relevant articles (454 outcomes, 398 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pathologic Constriction (Stenosis)
2.	Gastroesophageal Reflux (GERD)
3.	Neoplasms (Cancer)
4.	Pain (Aches)
5.	Esophageal Neoplasms (Esophageal Cancer)

Experts

1.	Siersema, Peter D: 37 articles (12/2014 - 03/2003)
2.	Song, Ho-Young: 19 articles (06/2015 - 03/2003)
3.	Siersema, P D: 13 articles (10/2013 - 02/2000)
4.	Kuipers, Ernst J: 13 articles (07/2012 - 03/2003)
5.	Nguyen, Nam P: 13 articles (01/2012 - 03/2005)
6.	Kim, Jin Hyoung: 12 articles (06/2015 - 06/2008)
7.	Vleggaar, Frank P: 12 articles (12/2014 - 12/2008)
8.	Vos, Paul: 12 articles (01/2012 - 03/2005)
9.	Sallah, Sabah: 12 articles (08/2009 - 03/2005)
10.	Smith, Herbert J: 12 articles (08/2009 - 03/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Deglutition Disorders:

1.	Botulinum Toxins (Botulinum Toxin)IBA 11/01/1999 - "These results show that: (1) previous pneumatic dilatation did not affect the results of myotomy; (2) in patients who did not respond to botulinum toxin, the myotomy was technically straightforward and the outcome was excellent; (3) in patients who responded to botulinum toxin, the LES muscle had become fibrotic (perforation occurred more often in this setting, and dysphagia was less predictably improved); and (4) myotomy relieved dysphagia in 91% of patients who had not been treated with botulinum toxin. " 05/01/2006 - "We describe 2 patients whose dysphagia was due to cricopharyngeal muscle over-activity and who significantly improved after a percutaneous botulinum toxin injection in the cricopharyngeal muscle in combination with a rehabilitation treatment (dietary modifications, postural techniques, airflow protection manoeuvres). " 11/01/2013 - "In a previous pilot study, we demonstrated that a single injection of botulinum toxin A (BTX-A) in the cricopharyngeus muscle is effective in patients with neurologic dysphagia with upper esophageal sphincter (UES) opening dysfunction and presence of some pharyngeal contraction (>25 mmHg). " 02/01/2013 - "We sought to review the dysphagia-related outcomes and quality of life in a series of patients with upper esophageal sphincter (UES) dysfunction treated with cricopharyngeal (CP) botulinum toxin (BTX) injection, and to identify patient characteristics or CP muscle histologic features that predict efficacy of BTX injection. " 10/01/2012 - "SCM thickness was <1.1 cm. US combined with EMG guidance eliminated recurrent dysphagia after botulinum toxin treatment, possibly by keeping the injectate within the SCM."
2.	1-phenyl-3,3-dimethyltriazene (PDT)IBA 05/01/1997 - "After PDT, excellent palliation of the dysphagia was seen in all of the patients, with a mean improvement in the dysphagia score of 2.25 and a mean dysphagia-free interval of 92 days. " 09/01/2012 - "At 4 weeks post-PDT, a significant improvement in the dysphagia score was observed in 90% of patients, from 2.75 ± 0.91 to 1.05 ± 0.83 (p < 0.05). " 04/01/2000 - "The dysphagia score improved by one to three levels in all patients, with a significant difference in favor of PDT (p = 0.0003). " 06/01/1999 - "PDT is effective in palliating patients with malignant dysphagia. " 11/01/2003 - "In 85% of courses for obstruction, mean dysphagia scores improved pre- and post-PDT. "
3.	BariumIBA 09/01/2001 - "All patients responded well to treatment, with significant relief of dysphagia and improvement in health and barium study findings. " 04/01/2014 - "All patients noted improvement in dysphagia with 9 of 10 patients demonstrating significant advancement of diet by modified barium swallow. " 05/22/1985 - "Eighty-three percent of patients were symptom free with normal barium meals five to nine years postoperatively, 11% had only minor reflux or dysphagia and were greatly improved as compared with their preoperative state and 6% suffered significant recurrence of symptoms. " 05/01/1993 - "We investigated the frequency with which changes in the position of a patient's head or body eliminated aspiration of liquid barium during videofluoroscopic swallowing studies in patients with oropharyngeal dysphagia. " 01/01/1997 - "Videofluoroscopic examination with the modified barium swallow may be helpful in planning suitable feeding regimes for dysphagia in MND."
4.	onabotulinumtoxinA (Botox)FDA Link 02/12/2013 - "Significant mean PAS reduction was noted at weeks 2 and 4. The botulinum-dependent PAS reduction was entirely associated with the variability shown by the group of patients with no sign of LMN impairment (group 2) and was not observed in group 1. The significant improvement observed in patients with isolated UES dysfunction suggests that a different pathophysiology of ALS dysphagia predisposes patients to a different response to treatment with BoTox-A. " 06/01/1999 - "Dysphagia improved significantly after the operation in both groups (botox group, from preoperative score of 3. 8 to a postoperative score of 0.7; non-botox, from a score of 3.4 preoperatively to 0.5 postoperatively). " 08/01/1997 - "There are three reports in the literature regarding the use of Botox to treat cricopharyngeal dysphagia, all describing good results. " 08/01/1999 - "Both BoTox and Lap-HM were effective in improving dysphagia score: before BoTox (median, 7; range, 0-10) and 2 months afterward (median, 2; range, 0-6) (p < 0. " 12/01/2004 - "Dysphagia improved in 8 of 11 (72.7%) patients who failed to respond to BoTox and underwent myotomy. "
5.	PlasticsIBA 01/01/2015 - "Pharyngeal electrical stimulation (PES) is a novel intervention designed to promote plastic changes in the pharyngeal motor cortex to aid dysphagia rehabilitation. " 02/01/2008 - "A working group of experts in swallowing and dysphagia reviews 10 principles of neural plasticity and integrates these advancing neural plastic concepts with swallowing and clinical dysphagia literature for translation into treatment paradigms. " 12/01/2007 - "Palliation of malignant esophageal Dysphagia: would you like plastic or metal?" 03/01/2002 - "Two children aged three and seven years presented to the department of Otolaryngology with total dysphagia following the accidental swallowing of a steel ball bearing and a plastic ball. " 06/01/1999 - "The mean pre-operative dysphagia score in both groups was 3, and immediately postoperatively the score was 0 in the Wallstent group and 2 in the plastic tube group. "
6.	Omeprazole (Esomeprazole)FDA LinkGeneric 09/01/2006 - "Because of its potent and long duration of action on gastric juice pH, this intravenous formulation of omeprazole may show promise for treatment of equine gastric ulcer syndrome (EGUS) in horses with dysphagia, gastric reflux, or other conditions that restrict oral intake of omeprazole paste. " 01/01/2005 - "He was commenced on esomeprazole for gastroesophageal reflux symptoms and his dysphagia improved significantly. " 06/01/2013 - "Dysphagia and rectal flatulence were less common during treatment with esomeprazole than at baseline or after surgery. " 06/01/2013 - "In contrast, dysphagia and increased flatus were found more often after surgery than during treatment with esomeprazole. " 04/01/1994 - "Omeprazole heals esophagitis and relieves dysphagia more efficaciously than H2RA while decreasing costs to patients."
7.	IronIBA 11/01/2015 - "Conversely to adults, endoscopic dilation was often necessary because dysphagia resisted iron supplementation. " 05/01/2014 - "The PVS described in this report had a distinct clinical course, showing very rapid improvement of dysphagia and esophageal web after 2 weeks of oral iron therapy. " 01/01/2013 - "While literature review elucidates the resolution of dysphagia in most cases with iron therapy, we discuss our case where the dysphagia was resistant to such therapy and necessitated a mechanical dilatation." 02/01/2010 - "Reversible sideropenic Dysphagia in a toddler with iron deficiency." 05/01/2007 - "It is characterized by dysphagia, iron deficiency and the presence of superior esophageal web. "
8.	salicylhydroxamic acid (SHAM)IBA 03/01/2009 - "Real rTMS led to a significantly greater improvement compared with sham in dysphagia and motor disability that was maintained over 2 months of follow-up. " 04/01/2011 - "Patients who received anodal tDCS gained 2.60 points of improvement in Dysphagia Outcome and Severity scale scores compared to patients in the sham stimulation group who showed an improvement of 1.25 points (P=0.019) after controlling for the effects of other aforementioned variables. " 05/01/2010 - "Active rTMS improved dysphagia compared with sham rTMS in both groups of patients, (p=0.001 for both); the LMI group also improved the scores in the Barthel Index. " 02/01/2001 - "Improvement in dysphagia comparing sham to balloon on day 1 was 66% versus 67% (p = 0.99); at 3 months it was 82% versus 76% (p = 0.56); and at 6 months it was 84% versus 73% (p = 0.38). " 08/01/2014 - "However, these preliminary results warrant further investigation concerning their clinical applicability, and further research should be based on randomized sham-controlled trials to determine the effectiveness and long-term effects of different therapies for dysphagia in PD."
9.	Proton Pumps (Proton Pump)IBA 04/01/2013 - "Seven of the 9 patients had dysphagia symptoms, which improved in 4 of 6 patients who were treated with proton pump inhibitor. " 03/01/2004 - "Twelve patients had been treated with a proton pump inhibitor and only 3 reported some improvement in the severity of dysphagia. " 01/23/2016 - "In this case, a patient with NCCP and dysphagia who was unresponsive to proton pump inhibitor treatment had an increased esophageal mast cell infiltration and responded to 14 days of antihistamine and antileukotriene treatment. " 02/01/2015 - "Proton pump inhibitor (PPI) use was significantly associated with frequent (3.1, 95% CI 2.2, 4.4) and infrequent dysphagia (1.5, 955 CI 1.3, 1.8). " 08/01/2014 - "Patients had dysphagia and met endoscopic criteria consistent with current EoE histologic criteria while on chronic proton-pump inhibitor therapy. "
10.	Phenobarbital (Luminal)FDA Link 02/01/1996 - "The use of fluoroscopic guidance impacts favorably on the efficacy of Maloney dilation, resulting in greater relief of dysphagia and increased luminal patency compared to the blinded technique. " 03/01/1986 - "Luminal diameter is increased with this method; symptomatic improvement in dysphagia occurred in all patients after one course of therapy. " 01/01/2011 - "Of the 135 patients enrolled, 122 completed the study; 100 patients had nonobstructive dysphagia, while 22 patients had a luminal finding which could explain their dysphagia. " 02/01/1996 - "We designed this prospective, randomized, single-blinded study to determine whether fluoroscopic guidance has an impact on relief of dysphagia and achievement of luminal patency. " 01/01/2016 - "The goal of esophageal dilation is to increase the luminal diameter of the esophagus while also improving dysphagia symptoms. "

Therapies and Procedures

1.	Stents 02/01/2010 - "Placement of self-expanding stents is highly effective for instant dysphagia relief, enabling adequate oral nutrition during neo-adjuvant therapy, but is limited by a high re-intervention rate." 04/01/2009 - "According to our data self-expanding metal stents are highly effective and safe for improving dysphagia. " 10/01/1998 - "The dysphagia improved dramatically after the stent was removed." 08/01/2000 - "In all patients, marked improvement of dysphagia was achieved with the use of metallic stents. " 03/01/1997 - "In malignant esophageal obstruction, both stents markedly improved dysphagia. "
2.	Fundoplication 12/01/1999 - "There are, however, a subset of patients who seem to have improvement with effective medical or surgical therapy, parodoxically, the same patients in whom a fundoplication, particularly a complete wrap, would lead to severe postoperative dysphagia secondary to preoperative dysmotility. " 07/01/2008 - "Our experience confirms the good results obtained with Nissen fundoplication with a distinct, rapid reduction in postoperative dysphagia." 11/01/2007 - "After fundoplication, dysphagia frequency and severity significantly improved for all patients. " 10/01/2000 - "For patients whose oesophageal manometric findings were normal there was a significant improvement in dysphagia after Nissen fundoplication (P = 0.02), and no significant change following Toupet fundoplication. " 07/01/1997 - "There was a significant reduction of dysphagia following the Toupet fundoplication. "
3.	Aftercare (After-Treatment) 10/01/1992 - "In 22 of 32 patients alive at least 6 weeks after treatment dysphagia improved, in 14 this relief was complete. " 09/01/2014 - "All 10 patients demonstrated improvement in dysphagia after treatment, which persisted during a mean follow-up time of 379 days (range 63-496 days). " 08/01/2010 - "Dysphagia score and regurgitation symptoms improved substantially after treatment. " 12/01/2008 - "The mean EAT-10 score of the patients with dysphagia improved from 19.87 +/- 10.5 to 5.2 +/- 7.4 after treatment (p <0.001). " 10/01/2007 - "After treatment with 70 mg of PSL for 4 weeks, VF showed improvement of dysphagia. "
4.	Brachytherapy 06/01/2013 - "Patients receiving SEMS followed by brachytherapy had significantly improved dysphagia at FU1 compared to patients receiving brachytherapy alone (n=35). " 03/01/2008 - "Brachytherapy has been shown to be beneficial in patients with an expected survival of longer than 3 months with regard to (prolonged) dysphagia improvement, complications and quality of life. " 04/01/1997 - "Eleven patients received 40.5 Gy in 27 fractions over 9 days, followed by a single high-dose-rate intraluminal brachytherapy insertion of 15 Gy at 1 cm. Acute toxicity was well tolerated and dysphagia was improved in 35 patients (65%), with 28 (52%) eating a normal diet by week 12. " 11/01/1996 - "In conclusion, brachytherapy before EBRT was a safe and effective procedure to induce rapid relief of dysphagia, especially when combined with EBRT." 01/01/1996 - "When external irradiation was combined with brachytherapy, dysphagia was more relieved than with brachytherapy alone (89% vs. 71%), with no increase in complication rates. "
5.	Radiotherapy 11/01/2013 - "This resulted in a significant reduction of severe dysphagia 3months after radiotherapy. " 02/01/2015 - "Another common toxicity of radiotherapy is dysphagia, which alters the nutritional status and quality of life of patients in remission. " 10/01/2012 - "Following radiotherapy, 75% of patients experienced an improvement in dysphagia and 25% of patients gained weight. " 03/01/1992 - "Dysphagia was improved by radiotherapy in 77.3% of cases, the median duration of relief was 24 weeks (range 0-208 weeks) and was maintained until death in 40%. " 11/01/2014 - "The aims of this study were to determine the prevalence, severity, morbidity, time course and reporting patterns of dysphagia symptoms after head and neck radiotherapy. "