points in the history

Last reviewed 12/2022

• some clinical features that may be associated with dysphagia include:
  • coughing and choking while or soon after eating or drinking
  • wet sounding voice associated with eating
  • chest congestion after eating or drinking
  • slow eating
  • a single mouthful of food taken in as multiple swallows
  • extra effort while chewing or swallowing
  • tiredness while eating
  • rise of temperature thirty minutes to an hour after eating
  • weight loss
  • change in laryngeal sensation
  • food coming out of the nose
  • pain while swallowing 
  • feeling of a lump in the throat
  • recurrent pneumonia

• the folowing specific points in the history obtained about a dysphagic patient are also diagnostically helpful:
  • regarding the swallowing of fluid:
• if the patient can swallow fluid as quickly as usual but has difficulty with food apparently getting stuck, then suspect a stricture. It may be benign or malignant.
• if the patient cannot swallow fluid as quickly as usual, then this suggests that there is either a motility disorder such as achalasia, a neurological disorder, or a severely narrowed oesophageal lumen
• if the neck bulges or gurgles on drinking, then suspect a pharyngeal pouch
• regarding the movement of swallowing
  • if constant and painful then suspect a malignant stricture
• the rapidity of onset is important - see aetiology