Dysphagia history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

The most important factor in the evaluation of all types of dysphagia is a detailed history, and a thorough review of symptoms that can differentiate esophageal from oropharyngeal dysphagia and help predict the specific etiology. How a patient describes the symptoms and their timing, associated historical features, and other characterizations may specifically denote the anatomic level of swallowing dysfunction.

History

Obtaining the history is the most important aspect of making a diagnosis of dysphagia. It provides insight into the cause, precipitating factors and associated comorbid conditions. Specific points to focus in history of patient presenting with dysphagia include

Past Medical History
- Recent stroke
- Neuromuscular disease
- Hypertension
- Diabetes mellitus (DM)
- Thyroid disease
- Cancer

Medication history
- History of use of any medications such as:
Social History
- History of alcohol and smoking
Travel history (Chaga’s disease)

Symptoms of Dysphagia

Common symptoms

Common symptoms of dysphagia include:^[1]^[2]^[3]^[4]^[5]^[6]

Symptoms
Oropharyngeal dysphagia	Esophageal dysphagia
Coughing or choking with swallowing Difficulty initiating swallowing Food sticking in the throat Sialorrhea Unexplained weight loss Change in dietary habits Recurrent pneumonia Change in voice or speech Nasal regurgitation	Sensation of food sticking in the chest or throat Change in dietary habits Recurrent pneumonia Symptoms of gastroesophageal reflux disease (GERD) including Heartburn Belching Sour regurgitation, and water brash

Less common symptoms

Less common symptoms of dysphagia include:

Weight loss

Anemia

Heartburn

References

↑ Jamieson J, Hinder RA, DeMeester TR, Litchfield D, Barlow A, Bailey RT (1989). “Analysis of thirty-two patients with Schatzki’s ring”. Am J Surg. 158 (6): 563–6. PMID 2589590.
↑ Hendrix TR (1980). “Schatzki ring, epithelial junction, and hiatal hernia–an unresolved controversy”. Gastroenterology. 79 (3): 584–5. PMID 7429120.
↑ Bakari G, Benelbarhdadi I, Bahije L, El Feydi Essaid A (2014). “Endoscopic treatment of 135 cases of Plummer-Vinson web: a pilot experience”. Gastrointest Endosc. 80 (4): 738–41. doi:10.1016/j.gie.2014.05.332. PMID 25085338.
↑ Bakshi SS (2016). “Plummer-Vinson Syndrome”. Mayo Clin Proc. 91 (3): 404. doi:10.1016/j.mayocp.2015.11.002. PMID 26944249.
↑ Lind CD (2003). “Dysphagia: evaluation and treatment”. Gastroenterol Clin North Am. 32 (2): 553–75. PMID 12858606.
↑ Navaneethan, Udayakumar; Eubanks, Steve (2015). “Approach to Patients with Esophageal Dysphagia”. Surgical Clinics of North America. 95 (3): 483–489. doi:10.1016/j.suc.2015.02.004. ISSN 0039-6109.

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[pmid2589590-1] Jamieson J, Hinder RA, DeMeester TR, Litchfield D, Barlow A, Bailey RT (1989). “Analysis of thirty-two patients with Schatzki’s ring”. Am J Surg. 158 (6): 563–6. PMID 2589590.

[pmid7429120-2] Hendrix TR (1980). “Schatzki ring, epithelial junction, and hiatal hernia–an unresolved controversy”. Gastroenterology. 79 (3): 584–5. PMID 7429120.

[pmid25085338-3] Bakari G, Benelbarhdadi I, Bahije L, El Feydi Essaid A (2014). “Endoscopic treatment of 135 cases of Plummer-Vinson web: a pilot experience”. Gastrointest Endosc. 80 (4): 738–41. doi:10.1016/j.gie.2014.05.332. PMID 25085338.

[pmid26944249-4] Bakshi SS (2016). “Plummer-Vinson Syndrome”. Mayo Clin Proc. 91 (3): 404. doi:10.1016/j.mayocp.2015.11.002. PMID 26944249.

[pmid12858606-5] Lind CD (2003). “Dysphagia: evaluation and treatment”. Gastroenterol Clin North Am. 32 (2): 553–75. PMID 12858606.

[NavaneethanEubanks2015-6] Navaneethan, Udayakumar; Eubanks, Steve (2015). “Approach to Patients with Esophageal Dysphagia”. Surgical Clinics of North America. 95 (3): 483–489. doi:10.1016/j.suc.2015.02.004. ISSN 0039-6109.

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