Dysphagia

Question 1

Common causes and investigations for dysphagia?

Answer 1

Mechanical blocks or motility disorders. Establishing time course and difference in swallowing solids/liquids, Endoscopy and barium swallow are main investigations.

Question 2

Symptoms of oesaphageal malignancy

Answer 2

Generally in >60. Progressive dysphagia (first solids, then liquids, then saliva), weight loss, anorexia, retrosternal chest pain, lymphadenopathy.

Question 3

The pathology and history of an oesaphageal malignant lesion

Answer 3

Squamous cell carcinoma occur at carina. Smoking and diet are risk factors. Adenocarcinomas develop following metaplasia (Barrett’s Oesophagus) caused by prolonged contact to acid reflux. they metastasise early to lymph nodes.
Risk factors: smoking, high alcohol, breast cancer therapy, achalasia, obesity, strictures and radiotherapy.