Definition
Dysphagia literally means difficulty with swallowing, which may be associated with ingestion of solids or liquids or both.
Key Points
- Most causes of dysphagia are oesophageal in origin.
- In children, foreign bodies and corrosive liquids are common causes.
- In young adults, reflux stricture and achalasia are common.
- In the middle aged and elderly, carcinoma and reflux are common.
- Because the segmental nerve supply of the oesophagus corresponds to the intercostal dermatomes, a patient with dysphagia can accurately pinpoint the level of obstruction.
- Any new symptoms of progressive dysphagia should be assumed to be malignant until proven otherwise. All need endoscopic ± radiological investigation.
- Tumour and achalasia may mimic each other. Endoscopy and biopsy are advisable unless the diagnosis is clear.
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