When a patient presents to you with dysphagia, think of how to classify and ask the following questions, keeping in mind all the conditions that predispose to or cause dysphagia, asking abou these in the systemic inquiry:
- Exact location where the patient feels that the food gets ‘stuck,’
- What substances are difficult to swallow? Liquids, solids or both?
- Any pain along with the dysphagia? (Odynophagia)
- Any history of previous similar episodes?
- In the systemic review, take a detailed history of all the conditions that can cause dysphagia such as multiple sclerosis, myasthenia gravis, stroke, etc (if any of these conditions are present, other findings and appropriate history of these diseases will also be present. For example, a patient with myasthenia gravis might give you a history of muscle weakness over the face, ptosis of the lids, nasal regurgitation, etc).
- Is there regurgitation of food/liquids whenever the patient tries to swallow?
The following three findings suggest serious disease and should never be taken lightly:
- Dysphagia accompanied by weight loss (indicator of malignancy),
- Severe and complete Dysphagia (showing signs such as drooling or complete failure to swallow anything at all, all of which indicate total obstruction) (indicators of malignancy),
- The development of a recent neurological deficit (this indicates a stroke).
- Dysphagia (merckmanuals.com)
- Dysphagia – Reasons, Types and Causes (theclinicaljournal.wordpress.com)
- Coping with Dysphagia (livingwithmyositis.wordpress.com)
- Understanding Dysphagia (a part of having Myositis) (sarchasm2.wordpress.com)
- Esophagus Problems Causes, Symptoms, Diagnosis, Treatment (healthhype.com)