PMH + DH

Question 1

Dysphagia GORD?

Answer 1

predisposes to oesophageal adenocarcinoma and non-malignant strictures. If GORD due to hiatus hernia has been corrected with fundoplication, then this is significant because the operation could tighten the lower oesophageal sphincter - this can cause post-operative dysphagia.

Question 2

Dysphagia peptic ulcer disease?

Answer 2

can lead to scarring and strictures around the gastric cardia and lower oesophagus.

Question 3

Dysphagia other history?

Answer 3

Also may have history of progressive neurological disease i.e. MS or Parkinsons.

Question 4

Dysphagia calcium channel blockers and nitrates?

Answer 4

relax smooth muscle, can cause reflux symtoms by reducing oesophageal tone.

Question 5

Dysphagia NSAIDs, aspirin, steroids, bisphosphonates

Answer 5

Predispose to peptic ulceration