Differential Diagnosis for Swallowing Issue

Single most likely diagnosis

• Gastroesophageal Reflux Disease (GERD): This is a common condition where stomach acid flows back into the esophagus, causing discomfort when swallowing. The absence of pain and the chronic nature of the symptoms make GERD a likely diagnosis.

Other Likely diagnoses

• Esophagitis: Inflammation of the esophagus, often caused by acid reflux or infection, can lead to discomfort when swallowing.
• Dysphagia due to muscle or nerve disorders: Conditions like achalasia or scleroderma can cause swallowing difficulties due to abnormal muscle or nerve function.
• Esophageal stricture or ring: Narrowing of the esophagus can cause discomfort or difficulty when swallowing.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

• Esophageal cancer: Although less common, esophageal cancer can present with swallowing difficulties and must be ruled out, especially in older adults or those with a history of smoking or alcohol use.
• Mediastinal mass or lymphadenopathy: A mass or enlarged lymph nodes in the mediastinum can compress the esophagus, causing swallowing difficulties.

Rare diagnoses

• Eosinophilic esophagitis: A rare condition characterized by an allergic reaction in the esophagus, leading to swallowing difficulties and food impaction.
• Zenker's diverticulum: A rare condition where a pouch forms in the pharynx, causing swallowing difficulties and regurgitation of food.
• Chagas disease: A rare parasitic infection that can cause swallowing difficulties due to esophageal dysfunction.