How I Approach Dysphagia

  title={How I Approach Dysphagia},
  author={Jooho P. Kim and Peter J. Kahrilas},
  journal={Current Gastroenterology Reports},
This review presents an overview of the diagnostic approach to esophageal dysphagia and summarizes recent epidemiological trends and technical advancements. The evaluation of dysphagia begins with a detailed history followed by endoscopy to evaluate for any structural abnormalities including malignancy. This is especially true given the emergence of eosinophilic esophagitis (EoE) as a dominant cause of esophageal dysphagia. In fact, it is now standard practice to obtain esophageal biopsies… Expand
8 Citations
Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
The esophageal motility disorders co-occurring with endoscopic and histological anomalies do not significantly affect the severity of dysphagia, however, in the case of patients with ERD and SR and concomitant UES insufficiency, this motor dysfunction has a significant impact on the reduction in the patients’ quality of life. Expand
Diagnosis in Muscle Tension Dysphagia.
The results showed that patients with MTDg were characterised by correct results of FEES examination, prolonged swallowing, features of inappropriate mucous and oropharyngeal muscle function, and the Swallowing Disorder Scale (SDS), developed by the authors, correlated best with the cause of dysphagia. Expand
Endoscopic Findings and Their Association With Gender, Age and Duration of Symptoms in Patients With Dysphagia
Dysphagia is associated with many endoscopic findings that are not related to demographic variables and must be evaluated earlier to reduce further morbidity and mortality. Expand
High-Resolution Esophageal Manometry in the Inpatient Setting: A Tertiary Referral Center Experience
The inpatient HRM group had unique characteristics and few subsequent interventions, and tolerance of oral diet and diabetes were associated with a lower likelihood of additional intervention. Expand
Protocolo diagnóstico de la disfagia
La endoscopia digestiva alta debe ser la primera prueba complementaria en la mayoria de los pacientes, sobre todo cuando se sospeche una causa mecanica, incluidas las lesiones malignas. Expand
Der Hals – erste Kontaktaufnahme zu einer Durchgangsstation
Der Hals ist eine Durchgangsstation zwischen Kopf, Rumpf und Extremitäten. Beschwerden in der Halsregion können komplex sein und Fachgebietsgrenzen überschreiten. In diesem Artikel wird eine Expand
The Stanford Multidisciplinary Swallowing Disorders Center.


Advances in Management of Esophageal Motility Disorders
Esophageal motility disorders are conceptualized as characterized by obstructive physiology at the esophagogastric junction, smooth muscle esophagus, or both, with the development of a minimally invasive technique for performing a calibrated myotomy of the esophileal circular muscle, the POEM procedure. Expand
Temporal trends in the relative prevalence of dysphagia etiologies from 1999-2009.
While total EGD volume did increase over the 10-year time period, the percentage of EGDs for the indication of dysphagia remained stable making increasing upper endoscopy an unlikely reason for the observed increased prevalence of EoE. Expand
Evaluation of Esophageal Motility Utilizing the Functional Lumen Imaging Probe
FLIP topography provides an alternative and complementary method to HRM for evaluation of non-obstructive dysphagia and may indicate otherwise undetected abnormalities of esophageal function, thus FLIP provides a well-tolerated method for esphageal motility assessment at the time of upper endoscopy. Expand
Endoscopic Findings in Patients Presenting with Dysphagia: Analysis of a National Endoscopy Database
The prevalence of endoscopic findings differs significantly by gender, age, and repeat procedure, and the most common findings in descending order were stricture, normal, EU, SR, EFI, and suspected malignancy. Expand
Esophageal distensibility as a measure of disease severity in patients with eosinophilic esophagitis.
  • F. Nicodème, I. Hirano, +7 authors J. Pandolfino
  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2013
Reduced esophageal distensibility predicts risk for food impaction and the requirement for esphageal dilation in patients with eosinophilic esophagitis and the severity of mucosal eOSinophilia was not predictive of these outcomes and had a poor correlation with esophagesibility. Expand
Severity of endoscopically identified esophageal rings correlates with reduced esophageal distensibility in eosinophilic esophagitis.
Endoscopic inflammatory features show a weak correlation with histopathology but should not replace histologic indices of inflammation and may be useful for food impaction risk stratification in EoE. Expand
Epidemiology and Natural History of Eosinophilic Esophagitis.
The data and potential reasons behind this increase, risk factors, and important areas for research into disease etiology are reviewed, as well as the progression of EoE from an inflammatory to fibrostenotic phenotype. Expand
Mechanical properties of the esophagus in eosinophilic esophagitis.
Esophageal distensibility, defined by the change in the narrowest measurable CSA within the distal esophagus vs intraluminal pressure was significantly reduced in EoE patients compared with controls. Expand
Efficacy of treatment for patients with achalasia depends on the distensibility of the esophagogastric junction.
Assessment of EGJ distensibility by EndoFLIP is a better parameter than LES pressure for evaluating efficacy of treatment for patients with achalasia and, in contrast to LESpressure, is associated with esophageal emptying and clinical response. Expand
Functional Lumen Imaging Probe for the Management of Esophageal Disorders: Expert Review From the Clinical Practice Updates Committee of the AGA Institute
A clinical practice update describes the technique and reviews potential indications in achalasia, eosinophilic esophagitis, and gastroesophgeal reflux disease. Expand