Type I: Dysphagia due to throat pain.

This is the commonest type of Dysphogia in General Practice, Occuring due to Acute Tonsilitis, Pharyngitis or Laryngitis.

Steam Inhalation 2-3 times/day. Add Tinc. Benzoin or Vicks/ Veporub to the boiling water.

Tab. ROXID 150mg bd x 5days (Respiratory antibiotic)

Tab. Combiflam 1tds x 3 days (ibuprofen + paracetamol)

Sovential expectorant tsp tds x if cough.

Soft or liquid diet, no chillies, no oily and irritant foods.

Gargle with warm salt water, or Wokadine oral solutions.

Adequate rest. Avoid exertion.

First Ask the patient to open the mouth, and inspect the throat using a good torch ad tongue depressor. If throat is not congested, think of true dysphagia – types 2 & 3.

If patient cannot open the mouth.

It’s quince.e Peritonsillar abscess if Painful.

Oral submucus fibrosis – if mucosa is white and

Tetanus if lockjaw.

Type 2: Painful Dysphagia with retrosternal burning and pain.

Bland and soft diet, more of milk. Avoid Hot drinks and spicy foods.

Ij. Neurobion 2cc IM x daily 5-10 inj. (B1 B6 B12)

Syp. Bplex 2tsp tds (Bplex, preferably syrup)

Mucain gel 2 tsp x 24 hourly (Antacid + Oxethazine)

Syp. Acigon 2tsp x 6 hourly if regurgitation symptoms, Alginic acid)

Tab. Ranitidine 150mg. Done (H2 antagonist)

If anemic, Treat iron deficiency first (2-1)

Inj. Imferon 2cc deep IM x daily x 10 days

Cap. Autrin 1 OD x 3 months.

If reflux oesophagitis or hiatus hernia, add:

Tab. Cisapride 10g. tds x 15 (Cisapride)

Syp. Acigon 2 tsp 6 hourly (Alginic acid)

Do not lie down, immediately after food Take small, non-bulky meals.

Head high position at night.

If pain and Dysphagia do not subcide with 1week. Refer for Iesophagoscopy and Barium swallow.

Type 3: Obstructive Dysphagia

If there is definite and progressive obstruction to the passage to the passage of solid foods – e.g any solid food taken regurgitates back or goes in only on drinking plenty of water,

Then do not waste tie giving medicines.

Refer for urgent, Barium swallow, indirect laryngoscopy and Oesophagoscopy.

Tab. Combiflam

Sovential expectorant

Inj. Neurobion

Syp. Bplex

Mucain gel

Syp. Acigon

Tab. Ranitidine

Inj. Imferon

Cap. Autrin

Tab. Cisapride