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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 is an alarm symptom that warrants prompt evaluation to define the exact cause and initiate appropriate therapy. It may be due to a structural or motility 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 evaluation of patients with dysphagia and diagnostic testing in patients with esophageal dysphagia. Our recommendations are largely consistent with the American Gastroenterological Association, the American Society for Gastrointestinal Endoscopy and the World Gastroenterology Organization guidelines [1-4]. The pathogenesis, diagnosis, and evaluation of patients with oropharyngeal dysphagia are discussed separately. (See "Oropharyngeal dysphagia: Etiology and pathogenesis" and "Oropharyngeal dysphagia: Clinical features, diagnosis, and management".)


The terms dysphagia, odynophagia, and globus sensation are defined as follows:

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

Odynophagia is pain with swallowing.

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Literature review current through: Nov 2017. | This topic last updated: Oct 26, 2017.
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