Pathology of Dysphagia, Esophageal pain, Achalasia cardia,

1. DYSPHAGIA
• Difficulty in swallowing r inability to
initiate swallowing
• Difficulty in swallowing solid- Sign of
obstruction
• Difficulty in swallowing solid & liquid
both- Sign of Motor dysfunction
• Odynophagia- Pain in swallowing

3. Causes of Dysphagia
• Fibrosis- Narrowing
• External compression- Tumor
• Diverticulum
• Congenital Atresia
• Congenital Fistulae

4. • Achalasia
• Neurological Damage to cranial nerve-
Parasympathetic-V, VII, IX, X
Tongue supply- XII

5. Esophageal Pain
• Heart Burn/ Pyrosis
• Cause-
• Reflux of Gastric content into esophagus-
High acidic content act as irritant to sensory
afferent nerve ending of mucosa
• It causes spasm of esophageal muscle

6. Clinical Manifestation
• Substernal burning sensation that may
radiate to neck or throat.
• Esophageal distention or powerful
esophageal contractions.
• Esophageal Obstruction
• Infection in immuno-compromised patient

7. • Esophageal pain is similar to Angina
Pectoris(both radiate to neck,
shoulder, jaw)
But
• Difference is that swallowing
worsens the esophageal pain

8. ACHALASIA CARDIA
• It is inability of lower esophageal
sphinter(LES) to relax- which
prevents food from passing from
stomach to esophagus.
• It is characterised by TRIAD
1. Incomplete LES reaxation
2. Increased LES tone
3. Aperistalsis of esophagus

11. Causes of Achalasia
• Primary Cause- Ganglionic cell
degenaration
• Secondry Cause- Chagas Disease
Trypanosoma cruzi infection destroy
myentric plexus failure of peristalsis.

12. Clinical Feature
• Dysphagia
• Regurgitation
• Chest Pain