Approach to dysphagia

This chapter discusses the background, prevention, diagnosis, treatment, and prognosis of dysphagia. Dysphagia occurs when a patient has difficulty transferring solid or liquid bolus from the oral cavity to the esophagus. There are two types of dysphagia: oropharyngeal dysphagia and esophageal dysphagia. Dysphagia results from the following two mechanisms: (i) a mechanical obstruction or structural abnormality, or (ii) a neuromotor defect. Primary care physicians can enquire about dysphagia on routine history-taking, particularly in the elderly population. Several imaging techniques are available including barium esophagram and videoflouroscopy. An esophageal manometry test can be performed to measure the pressure changes and look for any motility disorders. An endoscopy can be performed to look for structural abnormalities. There are several treatment options available for esophageal dysphagia, depending on the cause. The prognosis of dysphagia is good if diagnosed early and the correct cause has been found.