Approach to Dysphagia

Differential diagnosis

• Odynophagia
  • Oesophageal candidiasis
  • Caustic ingestion
  • Drugs
    • Doxycycline
    • Bisphosphonates
    • Anti-cholinergics (dry mouth)
• Inflammatory
  • Systemic sclerosis
  • Sjogren’s (dry mouth)
• Structural
  • Benign oesophageal stricture
  • Crohn’s stricture
  • Diffuse oesophageal spasm
  • Plummer-Vinson syndrome
  • Hiatus hernia
  • Post intubation
• Neoplastic
  • Oesophageal cancer
  • Barret’s oesophagus
  • Gastric cancer
• Neurological
  • Achalasia
  • Neuromuscular disease
    • Bulbar palsy
    • Pseudobulbar palsy
    • Motor neurone disease
    • Myotonic dystrophy
    • Parkinson’s disease
    • Multiple system atrophy
    • Myasthenia gravis
  • Cerebrovascular accident