Differential Diagnosis for Dysphagia with Weight Loss in a 16-year-old Male
Single Most Likely Diagnosis
- Eosinophilic Esophagitis: This condition is a common cause of dysphagia in adolescents, particularly males. It is characterized by an allergic inflammatory response in the esophagus, leading to difficulty swallowing and weight loss due to food avoidance.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause dysphagia and weight loss due to chronic inflammation and scarring of the esophagus. It is a common condition in adolescents and can be exacerbated by obesity, which may also contribute to weight loss efforts.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause dysphagia and weight loss due to malabsorption, chronic inflammation, and decreased appetite.
- Food Allergies or Intolerances: Adolescents may experience dysphagia and weight loss due to undiagnosed food allergies or intolerances, such as celiac disease or lactose intolerance.
Do Not Miss Diagnoses
- Esophageal Cancer: Although rare in adolescents, esophageal cancer can present with dysphagia and weight loss. It is essential to rule out this diagnosis due to its poor prognosis if left untreated.
- Achalasia: This rare motility disorder can cause dysphagia and weight loss due to the inability of food to pass through the esophagus. If left untreated, it can lead to severe malnutrition and other complications.
- Mediastinal Mass: A mass in the mediastinum, such as a lymphoma or teratoma, can compress the esophagus and cause dysphagia and weight loss.
Rare Diagnoses
- Esophageal Ring or Web: A congenital or acquired ring or web in the esophagus can cause dysphagia and weight loss due to obstruction of food passage.
- Scleroderma: This autoimmune disorder can cause dysphagia and weight loss due to esophageal fibrosis and decreased motility.
- Chagas Disease: This parasitic infection can cause dysphagia and weight loss due to destruction of the esophageal muscles and nerves. However, it is rare in non-endemic areas and typically affects older adults.