Differential Diagnosis for Progressive Dysphagia
Single Most Likely Diagnosis
- Achalasia: A motility disorder of the esophagus characterized by the failure of the lower esophageal sphincter to relax, leading to progressive dysphagia. It is a common cause of progressive dysphagia, especially in younger patients.
Other Likely Diagnoses
- Esophageal Cancer: A malignancy of the esophagus that can cause progressive dysphagia, initially to solids and eventually to liquids. Risk factors include smoking, alcohol use, and a history of Barrett's esophagus.
- Esophageal Stricture: A narrowing of the esophagus, often due to chronic gastroesophageal reflux disease (GERD), that can cause progressive dysphagia.
- Scleroderma: A systemic disease that can affect the esophagus, leading to fibrosis and decreased motility, resulting in progressive dysphagia.
Do Not Miss Diagnoses
- Esophageal Ring or Web: A mucosal structure that can cause intermittent or progressive dysphagia. Although less common, it is crucial to diagnose as it can be treated with dilation.
- Eosinophilic Esophagitis: A chronic inflammatory disease of the esophagus that can cause progressive dysphagia, food impaction, and heartburn. It is essential to diagnose as it requires specific treatment.
- Mediastinal Mass: A mass in the mediastinum that can compress the esophagus, leading to progressive dysphagia. Early diagnosis is critical as it may be a sign of an underlying malignancy.
Rare Diagnoses
- Chagas Disease: A parasitic infection caused by Trypanosoma cruzi that can lead to achalasia-like symptoms and progressive dysphagia in rare cases.
- Esophageal Leiomyoma: A rare, benign tumor of the esophagus that can cause progressive dysphagia due to its size and location.
- Amyloidosis: A systemic disease that can affect the esophagus, leading to progressive dysphagia due to the deposition of amyloid proteins.