The Importance of Clinical Examination in a Patient with Dysphagia: a Case Report
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MEDICINE
The Importance of Clinical Examination in a Patient with Dysphagia: a Case Report Hakan Gölaç 1
&
Güzide Atalık 1 & Ebru Şansal 2 & Metin Yılmaz 2
Accepted: 13 October 2020 # Springer Nature Switzerland AG 2020
Abstract The aim of this paper is to emphasize the importance of careful history taking in patients with dysphagia. Dysphagia is defined as the difficulty in forming or moving the foods and liquids safely from the mouth to the stomach. Traditionally, swallowing can be divided into four stages: oral preparatory stage, oral stage, pharyngeal stage, and esophageal stage. However, it has to be emphasized that the division of swallowing into different stages is artificial and the act of swallowing should be considered as a whole process. Therefore, a careful history taking will yield the likely underlying pathophysiologic process and anatomic site of the problem in most patients. Although patients explain their disease-related symptoms undoubtedly, it is necessary for the clinicians to be aware of some other suspicious pathologies. Herein, we present the case of a patient with Schatzki ring (SR) who had a feeling “something stuck in the throat” during ingestion of solid foods. Keywords Careful history taking . Dysphagia . Esophageal disorders . Schatzki ring
Introduction
patient with SR who had a feeling “something stuck in the throat” during ingestion of solid foods.
Dysphagia is defined as the difficulty in forming or moving the foods and liquids safely from the mouth to the stomach [1]. Esophageal structural changes (i.e., ring stricture, an extrinsic mass, or a tumor) are considered to be one of the primary causes of dysphagia. Schatzki ring (SR), which causes narrowing of the distal esophageal lumen, could result in symptoms of dysphagia [2]. Herein, we present the case of a
Case Presentation
This article is part of the Topical Collection on Medicine * Hakan Gölaç [email protected] Güzide Atalık [email protected] Ebru Şansal [email protected] Metin Yılmaz [email protected] 1
Department of Speech and Language Therapy, Faculty of Health Sciences, Gazi University, Ankara, Turkey
2
Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
A 75-year-old woman presented to our outpatient swallowing unit with an intermittent dysphagia history. Swallowing complaint was only for solid foods (meat, quince etc.) and had been occurring over the previous 6 years. It occurs 2–3 times a month with a feeling “something stuck in the throat.” She reported regurgitation of swallowed bolus immediately after the feeling. Asthma, hypertension, gastroesophageal reflux, and chronic erythematous gastritis were the concomitant diseases. There was no history of pneumonia, weight loss, phlegm, cough during eating, or any chewing difficulties. The patient did not report any dyspnea experience during or after swallowing. Oral examination showed a normal uvular symmetry, good velum movement, and a normal GAG reflex. Motor movements of oral and perioral structures were intact
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