dysphagia

DEFINITION of dysphagia

Dysphagia is difficulty or inability to swallow solids, liquids, or both due to impaired oropharyngeal or esophageal function.[^2][^5][^1] Dysphagia is an abnormal delay in the movement of a food bolus from the mouth to the stomach, classified as oropharyngeal (difficulty initiating swallow from weakened throat muscles or neurological problems) or esophageal (difficulty moving food through the esophagus from blockages, strictures, motility disorders, or extrinsic compression); causes include neurological disorders (stroke, Parkinson’s disease), structural abnormalities (strictures, tumors, achalasia, Zenker diverticulum), inflammatory conditions (GERD, eosinophilic esophagitis), and muscular conditions (scleroderma); complications include aspiration pneumonia, malnutrition, dehydration, and weight loss, requiring multidisciplinary diagnostic evaluation and treatment.

---

ETYMOLOGY of dysphagia

greek

• Dys-: greek prefix dus- = “bad, difficult, abnormal.”
• -phagia: Greek phageîn (φαγεῖν) = “to eat, swallow.”
• Literal: “Difficulty swallowing” or “abnormal eating/swallowing.”[^5]

---

Classification and Types

Type	Location/Phase	Characteristics
Oropharyngeal dysphagia	Mouth/throat (oral & pharyngeal phases)	Difficulty initiating swallow; choking, coughing, nasal regurgitation; weak throat muscles; neurological causes.[^2][^4]
Esophageal dysphagia	Esophagus (esophageal phase)	Food stuck in chest; sensation after swallowing initiated; structural or motility problems.[^2][^4][^5]

---

Coding Context

ICD-10-CM:

Code	Description
R13.10	Dysphagia, unspecified.
R13.11	Dysphagia, oral phase.
R13.12	Dysphagia, oropharyngeal phase.
R13.13	Dysphagia, pharyngeal phase.
R13.14	Dysphagia, pharyngoesophageal phase.
R13.19	Other dysphagia.

Associated diagnoses:

• I69.391 - Dysphagia following cerebral infarction (stroke).
• K22.0 - Achalasia of cardia.
• K22.2 - Esophageal obstruction.
• K21.9 - GERD.

CPT Codes (Procedures):

• 43197 - Esophagoscopy, flexible, diagnostic.
• 74230 - Swallowing function study (modified barium swallow/videofluoroscopy).
• 91010 - Esophageal motility study (manometry).
• 92610-92617 - Swallowing evaluation/training by SLP.
• 43450 - Dilation of esophagus.

---

Causes and Etiology

Oropharyngeal dysphagia causes:[^6][^2][^3]

• Neurological: Stroke, Parkinson’s disease, MS, muscular dystrophy, brain injury, ALS.
• Structural: Zenker diverticulum, tumors, cleft palate, dental problems.
• Muscular: myasthenia gravis, dermatomyositis, scleroderma.

Esophageal dysphagia causes:[^1][^2][^5]

• Motility disorders: Achalasia, diffuse esophageal spasm, scleroderma.
• Structural/obstructive: Esophageal strictures, tumors, Schatzki rings, webs, paraesophageal hernia.
• Inflammatory: GERD, eosinophilic esophagitis, radiation esophagitis, caustic ingestion.
• Extrinsic compression: Enlarged blood vessels, thyroid, lymph nodes.

---

Clinical Features

Symptoms:[^4][^7][^2][^6]

• Sensation of food stuck in throat or chest.
• Pain while swallowing (odynophagia).
• Choking, coughing, or gagging when swallowing.
• Regurgitation of food or liquids.
• Nasal regurgitation.
• Drooling, inability to control saliva.
• Hoarseness, wet voice.
• Frequent heartburn.
• Weight loss, malnutrition.
• Recurrent pneumonia (aspiration).

Three phases of swallowing:[^6]

1. Oral phase: Voluntary; chewing, tongue movement to form bolus.
2. Pharyngeal phase: Involuntary; epiglottis closes, bolus passes through throat.
3. Esophageal phase: Involuntary; peristalsis moves bolus to stomach.

---

Related Terms

• odynophagia: Painful swallowing (different from dysphagia).
• Aspiration: Food/liquid entering airway/lungs.
• Achalasia: Failure of lower esophageal sphincter to relax.
• Zenker diverticulum: Pouch in upper esophagus collecting food.
• Eosinophilic esophagitis (EoE): Allergic/immune esophageal inflammation.
• Stricture: Narrowing of esophagus from scarring.
• Videofluoroscopy/VFSS: Modified barium swallow study (gold standard diagnostic).
• FEES: Fiberoptic endoscopic evaluation of swallowing.

---

DERIVATIONS of dysphagia

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(roots, (word) => econtains([[]].roots, word))) > 0 AND file.name != [[]].file.name
SORT file.name ASC

---

Query functionality

TABLE definition AS Definition
FROM #medterm 
WHERE file.name != this.file.name
AND any(contains(definition, split(this.definition, " ")))

Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms