Hello and welcome to Gastroenterology!
We will be walking through the entire GI system.
From the mouth,
through the oesophagus,
through the stomach, through the intestine
and out through the anus.
At first we'll begin with the esophagus itself and
with the esophagus, there's a topic
known as dysphagia.
And dysphagia to you should automatically
bring about many differentials
and the behaviour of dysphagia
becomes important to you.
What does dysphagia mean?
The patient says, "Hey Doc, I feel
like there's something sticking in my throat."
Causes include, maybe mechanical obstruction.
So when we talk about
the behaviour of dysphagia,
what kind of swallowing difficulty
is the patient actually feeling?
There's a possibility that there might be
a mechanical obstruction by that
maybe, perhaps the lower esophagus sphincter
is not properly opening.
Welcome to achalasia.
Maybe perhaps there's a tumour within the
esophagus making it difficult to properly swallow.
So therefore, the behaviour of the dysphagia becomes
a little bit different.
Is the patient experiencing
dysphagia to solids? Liquids?
What about the timing?
Was the solids first, then liquids?
Was it at the same time?
All of this will then tell you as to what
the diagnosis of your patient will be.
There's another term here called odynophagia.
Odynophagia means pain upon swallowing.
It is important that you be able to
properly understand the language.
Whenever you hear about painful swallowing,
this to you hire in a differential
should perhaps mean that the patient has suffered
or experienced an infection or maybe perhaps trauma -
Often times your patient will say, "Hey Doc,
Patient doesn't know any better because the patient
is feeling a burning sensation within the chest
and so therefore describes it exactly as such.
But to you heartburn could mean, "Oh, maybe
perhaps there might be esophagitis",
or if there is such heartburn,
the patient doesn't know any better and might
be actually experiencing a myocardial infarction.