dysfagiassa

Dysfagiassa is a term occasionally found in sources to denote disfagia, the sensation of difficulty swallowing. The standard Italian term is disfagia, while dysphagia is used in English. In clinical practice disfagia is categorized by the site of the problem: oropharyngeal (oropharyngoesophageal) dysphagia, where the bolus fails to move from the mouth into the esophagus, and esophageal dysphagia, where the passage through the esophagus is impaired.

Symptoms commonly include a persistent sense of food sticking in the throat or chest, coughing or choking during meals, nasal regurgitation, difficulty handling liquids, and unintentional weight loss in chronic cases. The presentation may be sudden or gradually progressive, and aspiration can lead to respiratory infections.

Causes are diverse. Oropharyngeal dysphagia arises from neuromuscular diseases (such as stroke, Parkinson disease, amyotrophic lateral sclerosis), brain injury or dementia, myasthenia gravis, or structural lesions like diverticula. Esophageal dysphagia is often due to mechanical obstruction (peptic strictures, rings, webs, tumors) or inflammatory conditions (eosinophilic esophagitis), and can result from motility disorders (achalasia, diffuse esophageal spasm, hypomotility) or medication-induced injury.

Diagnosis integrates history and examination with specialized tests. Endoscopy (esophagogastroduodenoscopy) identifies structural disease, while videofluoroscopic swallow studies assess swallowing dynamics. Esophageal manometry evaluates motility. Additional tests may include pH monitoring for reflux.

Management targets the underlying cause and may include dietary modifications (soft or pureed foods, thickened liquids), swallow therapy with a speech-language pathologist, medical treatment for reflux or inflammation, and endoscopic or surgical interventions (dilation for rings or strictures, botulinum toxin for certain motility disorders). Prognosis varies with etiology and timeliness of treatment.