Dysphagia

Question 1

Define dysphagia

Answer 1

difficulty with the act of swallowing solids or liquids

Question 2

How can we classify causes of dysphagia?

Answer 2

Extrinsic
Oesophageal wall
Intrinsic
Neurological

Question 3

What are extrinsic causes of dysphagia?

Answer 3

Mediastinal masses

Cervical spondylosis

Question 4

What are the oesophageal wall related causes of dysphagia?

Answer 4

Achalasia
Diffuse oesophageal spasm
Hypertensive LOS

Question 5

What are intrinsic causes of dysphagia?

Answer 5

Tumours

Strictures

Question 6

What are neurological causes of dysphagia?

Answer 6

Stroke
Parkinson’s
MS
Myasthenia Gravis

Question 7

What are the features of oesophageal cancer?

Answer 7

Dysphagia
Weight loss
Anorexia
Vomiting during eating

PMH: Barrett’s, GORD, smoking and EtOH

Question 8

What are the features of oesophagitis?

Answer 8

Heartburn history
Odynophagia (painful swallowing)
Systemically well

Question 9

What are the features of achalasia?

Answer 9

Dysphagia of both liquids and solids from the start
Heartburn
Regurgitation of food - may lead to cough, aspiration pneumonia etc

Question 10

What are the features of dysphagia in myasthenia gravis?

Answer 10

Other symptoms may include extraocular muscle weakness or ptosis

Dysphagia with liquids as well as solids

Question 11

What is the investigation for dysphagia?

Answer 11

Upper GI endoscopy

Swallowing studies if motility issue