Hx: Dysphagia Cheat Sheet (DRAFT) by med_panda

Durati­on-­hours / days / weeks / months /years
Site: where does food get stuck?
Solids or liquids or both : Solid only (mecha­nical problem –narrow lumen )
Both (neuro­mus­cular , motor problem e.g.: Achalasia)
Nature: progre­ssi­ve-slow (stricture or obstru­ction) or rapid (cancer) or interm­ittent (esoph­ageal spasm, rings, webs)
When does this happen: initiating , after initiating
Aggrav­ati­ng/­rel­ieving factors

- have this sensation without swallowing food? True dysphagia
- feel a lump in your throat? Globus
- feel the food going down when you swallow? Oropha­ryngeal or esophageal
- Symptoms relieved by repeated swallow: Motor disorders
- need to take a drink after swallowing solids? - To breakdown food may indicate obstru­ction
- Have to cut food into small pieces?
- Coughi­ng/­choking – oropha­ryngeal dysphagia
- Odynop­hag­ia-­eso­phageal inflam­mation
- Chest pain/d­isc­omfort, heartburn
- Regurg­ita­tio­n/r­efl­ux/­gur­gli­ng/­spl­utt­ering : GERD
- have to vomit occasi­onally when swallo­wing? If so, when? Regurg­itation
- have too much saliva or phlegm in your throat? Partial obstru­ction
- have problems swallowing your saliva? Neurom­uscular causes­/or­oph­ary­ngeal
- Sensit­ivity to hot or cold : Motor disord­ers­/spasm
If yes to any of the features above when does it happen: initiation of swallow, immedi­ately after or long after
- Fever
- Halito­sis­-ph­ary­ngeal pouch
- Dysphonia (pain/­dif­ficulty speaking) – muscle dystrophy
- Voice hoarse­ness- mass impinging on recurrent laryngeal nerve
- Speech change­s-n­eur­omu­scular disorders
- Weight loss – duration, how much weight loss, malignancy

have to vomit occasi­onally when swallo­wing? If so, when? Regurg­itation
- have too much saliva or phlegm in your throat? Partial obstru­ction
- have problems swallowing your saliva? Neurom­uscular causes­/or­oph­ary­ngeal
- Sensit­ivity to hot or cold : Motor disord­ers­/spasm

- Weight loss
- Bleeding: hemate­mesis
- Advance age
(often indicates malign­anc­y/c­ancer)

- Did you have this before?
- Have you ever been admitted to the hospital or came to the hospital for any conditions regarding your throat or neck?
- Any previous surgeries for certain marts of your throat or neck or spine?
- Any long standing diseases related to your muscles or your nerves

- Are you currently taking any medica­tion?
note: drugs that reduce salivary secretion such as antich­oli­nergics and anti histamine eg. anti emetics
- Do you have any allergies?

- Does anyone in your family have or had something similar?
- Do you know anyone in your family who may have suffered from cancer? or terminal illness

- Does anyone in your family have or had something similar?
- Do you know anyone in your family who may have suffered from cancer? or terminal illness

- Are you married?
- What do you do for work? (radiation exposure)
- Do you smoke? Does anyone at home smoke?
- Do you drink alcohol?
- What does your diet usually consist of? solids, liquids, hot, cold?

**Symptoms suggest deep inflam­mation or ulceration of the esophageal wall or intense spasm of the esophagus
- Infection
- Malignancy
- Cigarette smoking/ Alcohol
- Aspirin/ Non steroidal anti inflam­matory drugs (NSAID's)

Socrat­es/­OPQRSTU