dysphagia

Last edited 10/2022 and last reviewed 12/2022

Dysphagia

  • is difficulty in swallowing food or liquid
    • cause may be local or systemic.
  • is common, especially in old age
  • should be distinguished from the following two conditions
    • odynophagia : painful swallowing (frequently associated with dysphagia)
    • globus : sensation of a mass in the throat
  • can be grouped as :
    • oropharyngeal dysphagia
      • abnormalities of the initiation of swallowing reflex in the oropharynx
      • common in old age
      • commonest cause is stroke
    • oesophageal dysphagia
      • abnormalities of flow of the food bolus through the esophagus into the stomach
      • causes include:
        • achalasia, scleroderma,carcinomas, strictures

Key points (2):

  • new onset dysphagia in adults requires urgent direct access upper gastrointestinal endoscopy (to be done within two weeks); dysphagia associated with head and neck cancer red flags requires a suspected head and neck cancer pathway referral

  • in many cases malignancy is not found, but management of benign conditions, such as oesophageal dysmotility or gastro-oesophageal reflux, can be challenging

  • secondary sequelae of benign and malignant dysphagia include malnutrition and aspiration pneumonia: consider early input from dietetic and speech and language therapy teams

Reference:

Related pages:

aetiology

points in the history

investigations

management