Oesophageal dysphagia history taking

HISTORY FOR SHOULD BE DIVIDED WHEN MAKING THE DIAGNOSIS INTO EITHER

1. SOLIDS ONLY or SOLIDS AND LIQUIDS
2. INTERMITTENT or PROGRESSIVE

SOLIDS ONLY suggests mechanical obstruction, whereas SOLIDS AND LIQUIDS suggests a neuromuscular cause.


Causes


SOLIDS ONLY and INTERMITTENT

• Lower oesophageal ring

SOLIDS ONLY and PROGRESSIVE

• Cancer
• Peptic stricture

SOLIDS AND LIQUIDS and INTERMITTENT

• Diffuse oesophageal spasm

SOLIDS AND LIQUIDS and PROGRESSIVE

• Scleroderma
• Achalasia