The causes of difficulty in swallowing are:
systemic disorders
- cerebrovascular disease – TIA, CVA, etc.
- motor neurone disease
- scleroderma
oesophageal dysmotility
mechanical obstruction
- carcinoma
- benign stricture
One-third of patients with GORD have mild intermittent dysphagia due to dysmotility. An upper GI endoscopy is indicated to: biopsy the oesophagus; treat with balloon dilatation; make a video barium swallow examination. Any oropharyngeal obstruction necessitates ENT review. If results are negative, oesophageal manometry is indicated.
Use the following questions to help determine the origin of symptoms.
- Does it take longer than one second to pass food from the mouth to the esophagus?
- What type of food or liquids cause symptoms?
- Are symptoms intermittent or progressive?
- Is there heartburn?
References
Chilukuri P, Odufalu F, Hachem C. “Dysphagia.” Mo Med. 2018;115(3):206-210.