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Dysphagia

Etiology

Esophageal dysphagia

  • Mechanical obstruction (solids worse than liquids)
  1. Esophageal web, ring (eg, Schatzki's), or diverticulum (intermittent dysphagia, not progressive)
  2. Peptic stricture (chronic heartburn, progressive dysphagia)
  3. Esophageal cancer (progressive dysphagia, age >50)
  • Motility disorder (solids and liquids)
  1. Achalasia (progressive dysphagia)
  2. Diffuse esophageal spasm (intermittent, not progressive)
  3. Scleroderma (chronic heartburn)

Oropharyngeal dysphagia

  • Neurologic disorders
  1. Brainstem stroke, mass lesion
  2. Amyotrophic lateral sclerosis, multiple sclerosis, pseudobulbar palsy, postpolio syndrome, Guillain-Barré syndrome
  3. Parkinson's disease, Huntington's disease, dementia
  4. Tardive dyskinesia
  • Muscular and rheumatologic disorders
  1. Myopathy, polymyositis
  2. Oculopharyngeal dystrophy
  3. Sjögren's syndrome
  • Metabolic disorders
  1. Thyrotoxicosis, amyloidosis, Cushing's disease, Wilson's disease
  2. Drugs: anticholinergics, phenothiazines
  • Infectious disease
  1. Polio, diphtheria, botulism, Lyme disease, syphilis, mucositis (Candida, herpes)
  • Structural disorders
  1. Zenker's diverticulum
  2. Cervical osteophytes, cricopharyngeal bar, proximal esophageal webs
  3. Oropharyngeal tumors
  4. Postsurgical or radiation changes
  5. Pill-induced injury
  • Motility disorders
  1. Upper esophageal sphincter dysfunction

See related DDx

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Last updated: December 1, 2014

Citation

Zeiger, Roni F.. "Dysphagia." Diagnosaurus, 4th ed., McGraw-Hill Education, 2014. Emergency Central, emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114465/all/Dysphagia.
Zeiger RF. Dysphagia. Diagnosaurus. 4th ed. McGraw-Hill Education; 2014. https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114465/all/Dysphagia. Accessed April 22, 2019.
Zeiger, R. F. (2014). Dysphagia. In Diagnosaurus. Available from https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114465/all/Dysphagia
Zeiger RF. Dysphagia [Internet]. In: Diagnosaurus. McGraw-Hill Education; 2014. [cited 2019 April 22]. Available from: https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114465/all/Dysphagia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Dysphagia ID - 114465 A1 - Zeiger,Roni F, Y1 - 2014/12/01/ BT - Diagnosaurus UR - https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114465/all/Dysphagia PB - McGraw-Hill Education ET - 4 DB - Emergency Central DP - Unbound Medicine ER -