Abstract
BackgroundMedically unexplained oropharyngeal dysphagia (MUNOD) is a rare condition. It presents without demonstrable abnormalities in the anatomy of the upper aero-digestive tract or swallowing physiology. The aim of this case report is to discuss the unique presentation of OCD as chronic dysphagia.Case presentationA 65-year-old woman was admitted with dysphagia and weight loss in surgical department with history of undergoing repeated upper GI endoscopies and laryngoscopies. The patient was finally diagnosed to be suffering from chronic obsessive-compulsive disorder with poor insight and comorbid depression after 3 years of suffering and moving from hospital to hospital. The atypical presentation and poor insight were the major reasons for diagnostic difficulty in this particular case. The patient was given 60 mg fluoxetine and 2 mg risperidone which improved the patient’s symptoms by 40%.ConclusionThis case explains the possibility of obsessive-compulsive disorder in patients presenting with unexplained somatic symptoms. It also demonstrated the importance of a timely psychiatric diagnosis and treatment and highlights the importance about awareness of psychiatric illness in doctor community which can reduce patient suffering and unnecessary invasive procedures.
Highlights
Unexplained oropharyngeal dysphagia (MUNOD) is a rare condition
This case explains the possibility of obsessive-compulsive disorder in patients presenting with unexplained somatic symptoms
Unexplained oropharyngeal dysphagia (MUNOD) is described as dysphagia occurring without a demonstrable abnormality in the anatomy or physiology of upper aerodigestive tract [4]
Summary
This case report explores the issue of OCD not being diagnosed for almost 30 years and highlights the difficulty in diagnosing OCD with poor insight.
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