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Approach to the evaluation of dysphagia in adults

Ronnie Fass, MD
Section Editor
Mark Feldman, MD, MACP, AGAF, FACG
Deputy Editor
Kristen M Robson, MD, MBA, FACG


Dysphagia suggests the presence of an organic abnormality in the passage of solids or liquids from the oral cavity to the stomach. Patients' complaints range from the inability to initiate a swallow to the sensation of solids or liquids being hindered during their passage through the esophagus into the stomach.

This topic will review the initial evaluation of patients with dysphagia and diagnostic testing in patients with esophageal dysphagia. The pathogenesis, diagnosis, and evaluation of patients with oropharyngeal dysphagia are discussed separately. Our recommendations are largely consistent with the American Gastroenterological Association guidelines [1,2]. (See "Oropharyngeal dysphagia: Etiology and pathogenesis" and "Oropharyngeal dysphagia: Clinical features, diagnosis, and management".)


Dysphagia is defined as a subjective sensation of difficulty or abnormality of swallowing.

Odynophagia is defined as pain with swallowing.

Globus sensation is defined as a persistent or intermittent nonpainful sensation of a lump or foreign body in the throat with the occurrence of the sensation between meals and the absence of dysphagia or odynophagia. Major esophageal motility disorders, eosinophilic esophagitis, or gastroesophageal reflux should be excluded as the cause of symptoms. These criteria must be fulfilled for the last three months with symptom onset at least six months before a diagnosis of globus sensation can be made [3]. (See "Globus sensation".)


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Literature review current through: Jul 2017. | This topic last updated: Jun 27, 2017.
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