Peer Reviewed
Feature Article Gastroenterology
CPD
Complete 1.5 CPD hours

Investigating patients with difficulty swallowing: the importance of a thorough history

Ian J Cook
Go To
CPD
Abstract
A brief and logical history is the most useful diagnostic tool when investigating patients with dysphagia because it provides a reliable indication of the underlying pathology and dictates the subsequent investigative algorithm.
Key Points
  • A brief structured history is the single most important step in evaluating patients with dysphagia because it identifies the likely pathophysiological process in 85% of cases.
  • The history will generally reliably distinguish pharyngeal from oesophageal dysphagia and also a structural oesophageal disorder from dysmotility.
  • A common mistake is to confuse the common, purely sensory symptom of globus with dysphagia. The swallow is completely normal in patients with globus.
  • Endoscopy is almost invariably indicated in patients with dysphagia but, in some cases, a combination of endoscopy, radiography and oesophageal manometry is necessary to confirm a diagnosis.
  • The finding of a normal endoscopy and normal barium swallow does not adequately rule out a structural or mucosal oesophageal cause for dysphagia.
Get full access
Subscribe for full access to all articles
Buy this article

Single article purchases are temporarily unavailable due to site maintenance.

If you would like to purchase an article during this time, please email us at [email protected] with the article details and we'll assist you directly. We'll also let you know when online purchasing is available again.

Thank you for your patience and understanding.

Already a subscriber?