Dysphagia

Differential Diagnosis

• Oropharyngeal: difficulty initiating swallow, with choking
  • Neurological disorders: stroke, etc
• Esophageal: difficulty after swallowing
  • Structural: difficulty with solids, followed later by liquids
    • Peptic stricture
    • Lower esophageal (Schatzki) ring
    • Carcinoma
    • Eosinophilic esophagitis: young men with atopic phenotype, fails PPI
  • Motility: difficulty with solids and liquids
    • Achalasia
    • Diffuse esophageal spasm
    • Systemic sclerosis