Dysphagia DDx

Dysphagia – Differential Diagnosis

Common causes

• Pharyngitis / Tonsillitis
• Pharyngeal pouch
• Globus Hystericus
• Gastro oesophageal reflux
• Oesophageal spasm
• Achalasia
• Benign strictures & webs

Must Not Miss

• Epiglottitis
• Retropharyngeal abscess
• Malignancy
  • Oropharyngeal cancer
  • Oesophageal cancer
  • Mediastinal lymphoma
  • Gastric Cancer
• CVA

Easily missed

• Foreign body
• Parkinson’s disease
• Multiple sclerosis
• Motor Neurone Disease
• Myasthenia gravis
• Scleroderma
• Sjogren’s syndrome

Red flags

• Progressive painless dysphagia
• Weight loss
• Persistent Vomiting
• Haematemesis
• Systemic features (fever, night sweats, anorexia)
• Past history of Cancer /Oesophagitis
• Lymphadenopathy

Investigations to consider

• FBC, CRP/ESR
• U&Es, LFTs, Bone profile
• ECG
• CXR
• Barium swallow
• OGD
• Oesophageal manometry
• CT