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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Difficulty In Swallowing In A Paralytic Patient?

my father is paralytic for the last ten years on the right side he certainly vomitted in the night the vomit was like coffee black but no blood , he was given inj emset , inj robeloc now he has not vomitted but he has aproblem in swallowing , can anyone guide whats the best for him
Mon, 3 Jun 2024
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Internal Medicine Specialist 's  Response
Hi,

Difficulty in swallowing can be due to mechanical obstructive causes in the food bolus pathway or it could be neurological. Mechanical causes can be tumors, esophageal strictures, schatzki's ring etc. Neurological causes can be cerebrovascular accident affecting the muscles of swallowing leading to pooling of secretions, Parkinson's disease, dementia like Alzheimer's.

Since there is a history of vomiting coffee colored vomitus, I would like to get a detailed history on the past history of similar such episodes, any associated symptoms, history of seizures / loss of consciousness, history of maleana (tarry black stools) an whether he has difficulty in swallowing both solids and liquids.

Take the patient to the emergency at the earliest where a detailed clinical examination can be done to distinguish between mechanical and neurological causes. Furthermore, a CT head can be considered with or without an MRI scan to rule out a cerebrovascular accident. And an esophago-gastro-duodenoscopy can be considered to rule out any obstruction.

Another important aspect is to maintain his nutrition. The Emergency physician would run the necessary steps and decide on Ryle's tube feeding or other modes of nutritional supplementation.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Devi Venugopal Rita, Internal Medicine Specialist
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What Causes Difficulty In Swallowing In A Paralytic Patient?

Hi, Difficulty in swallowing can be due to mechanical obstructive causes in the food bolus pathway or it could be neurological. Mechanical causes can be tumors, esophageal strictures, schatzki s ring etc. Neurological causes can be cerebrovascular accident affecting the muscles of swallowing leading to pooling of secretions, Parkinson s disease, dementia like Alzheimer s. Since there is a history of vomiting coffee colored vomitus, I would like to get a detailed history on the past history of similar such episodes, any associated symptoms, history of seizures / loss of consciousness, history of maleana (tarry black stools) an whether he has difficulty in swallowing both solids and liquids. Take the patient to the emergency at the earliest where a detailed clinical examination can be done to distinguish between mechanical and neurological causes. Furthermore, a CT head can be considered with or without an MRI scan to rule out a cerebrovascular accident. And an esophago-gastro-duodenoscopy can be considered to rule out any obstruction. Another important aspect is to maintain his nutrition. The Emergency physician would run the necessary steps and decide on Ryle s tube feeding or other modes of nutritional supplementation. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Devi Venugopal Rita, Internal Medicine Specialist