الفهرس 
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Abstract
Dysphagia has been documented by the WHO as a medical disability involving the digestive system and causing increased morbidity and mortality. Dysphagia is a symptom that can be caused by various diseases that can affect any of the phases of deglutition and cause a serious deterioration in the quality of life of affected patients.
Rheumatoid arthritis (RA) is a chronic multisystem disorder of unknown etiology with an immune basis that manifests most commonly as a destructive polyarthritis that can affect the temporomandibular joint and small joints of the larynx including cricoarytenoid and cricothyroid joints. The estimated prevalence of swallowing dysfunction in Rheumatoid Arthritis patient population is 13.1% to 33.3%. Patients could present with dysphagia to different food consistencies, taking smaller bites, and chewing excessively for safe swallowing, discomfort in the throat or chest when swallowing, and the sensation of food sticking in the throat.
The aim of this study was to assess the prevalence of dysphagia symptoms in rheumatoid arthritis patients and assessment of the dysphagia using FEES in order to take the results into consideration when setting up a management plan.
This study included 30 patients diagnosed with Rheumatoid Arthritis and complained of dysphagia. A protocol of assessment was structured and applied in phoniatric Unit Beni-suef university hospital. The assessment protocol included history taking and FEES examination with the use of MFRRS for residue assessment and the 8 points penetration aspiration scale. The results of this study showed that the most reported type of dysphagia was for solids followed by fluids and the most reported symptoms were foreign body sensation, xerostomia, chewing problems and teeth problems.
As compensation mechanisms most of patients mentioned using fluids with solids, increased their mealtime and cut food into smaller pieces for easier and safer swallow. FEES assessment showed vallecular residue for fluids, semi solids and solids and showed pyriform residue for fluids and semi solids only. None of the patients had penetration or aspiration.