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Harrison's Principles of Internal Medicine, 18e | Part 2. Cardinal Manifestations and Presentation of Diseases > Section 6. Alterations in Gastrointestinal Function > | Chapter 38. Dysphagia Sections: Dysphagia: Introduction, Further Readings. Topics Discussed: deglutition disorders. Excerpt:"Dysphagiadifficulty with swallowingrefers to problems with the transit of food or liquid from the mouth to the hypopharynx or through the esophagus. Severe dysphagia can compromise nutrition, cause aspiration, and reduce quality of life. Additional terminology pertaining to swallowing dysfunction is as follows. Aphagia denotes complete esophageal obstruction, most commonly encountered in the acute setting of a food bolus or foreign body impaction. Odynophagia refers to painful swallowing, typically resulting from mucosal ulceration within the oropharynx or esophagus. It commonly is accompanied by dysphagia, but the converse is not true. Globus pharyngeus is a foreign body sensation localized in the neck that does not interfere with swallowing and sometimes is relieved by swallowing. Transfer dysphagia frequently results in nasal regurgitation and pulmonary aspiration during swallowing and is characteristic of oropharyngeal dysphagia. Phagophobia (fear of swallowing) and refusal to swallow may be psychogenic or related to anticipatory anxiety about food bolus obstruction, odynophagia, or aspiration.Swallowing begins with a voluntary (oral) phase that includes preparation during which food is masticated and mixed..."
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