Dysphagia

Question 1

Diffuse oesophageal spasm features

Answer 1

Intermittent dysphagia ± chest pain

Contrast swallow shows abnormal contractions

Question 2

What is achalasia

Answer 2

Loss of coordinated peristalsis in oesophagus and LOS fails to relax

Question 3

Achalasia presentation

Answer 3

Dysphagia
Regurgitation
Weight Loss

Question 4

Achalasia test findings

Answer 4

Manometry/contrast swallow show dilated tapering oesophagus

Question 5

Achalasia treatment

Answer 5

Endoscopic balloon dilatation
Heller’s cardiomyotomy with PPIs

Botox injection if non-invasive needed
Ca channel blockers/nitrates may help

Question 6

Benign oesophageal stricture causes

Answer 6

GORD
Corrosives
Surgery
Radiotherapy

Question 7

Benign oesophageal stricture treatment

Answer 7

Endoscopic balloon dilatation

Question 8

What is Plummer-Vinson syndrome

Answer 8

Post-cricoid dysphagia
Upper oesophageal web
Iron-deficiency

Question 9

5qs for dysphagia

Answer 9

Difficulty swallowing solids + liquids from start? (motility)
Difficult to initiate swallowing? (Bulbar palsy)
Painful swallowing? (ulceration)
Intermittent or constant and worsening? (spasm or malignant)
Neck bulge/gurgle on drinking? (pharyngeal pouch)