[Dysphagia] esophageal dysphagia

[eripley at yahoo.com (Irene Campbell-Taylor)]

http://www.car.ca/ethics/standards/index.html
  CAR Standard for Performance of Contrast Studies of the Pharynx and Oesophagus in the Adult
Approved: June 1994
  Excerpts:
  ?The modified barium swallow is a study of the swallowing mechanism by means of boluses of various textures and consistencies with manoeuvres appropriate to the individual patient. Other terms in current use are: "provocative barium swallow", "swallowing assessment", "specific barium swallow" and "therapeutic barium swallow"
   
  5. Gastroesophageal reflux
Usually part of the evaluation of the oesophagus, stomach and duodenum. However, in the context of the barium swallow, if reflux is suspected and does not occur spontaneously, a variety of means may be used to provoke it.
   
  QUALITY CONTROL
  The following controls should be applied to all barium swallows and oesophagrams:
  A. Once examinations are completed, the images must be checked by the radiologist before the patient is permitted to leave the department, and the technician must verify that the video or digital images are technically satisfactory.
  B. Poorly exposed, inadequately centered or positioned films and blurred films should be repeated as necessary. An inadequate video recording may need to be amended.
  C. An attempt should be made to resolve questionable radiologic findings before the patient leaves.
  D. Radiologic findings should be correlated with endoscopic surgical pathologic findings where available.
  E. The combined evaluation of the swallowing mechanism and oesophagus should not be dissociated because the level of symptomatology is not always precise or reliable and because there is a high frequency of associated disorders of the pharynx and oesophagus.
   


Dr I Campbell-Taylor
Clinical Neuroscientist
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