Differential Diagnosis for Difficulty Swallowing
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is often the most common cause of difficulty swallowing (dysphagia) due to chronic inflammation and irritation of the esophagus, leading to spasms or narrowing.
Other Likely Diagnoses
- Esophageal Stricture: Narrowing of the esophagus due to chronic inflammation or scar tissue, often from GERD, can cause difficulty swallowing.
- Esophagitis: Inflammation of the esophagus, which can be due to various causes including infection, allergies, or chemical injury, leading to dysphagia.
- Achalasia: A motility disorder of the esophagus characterized by the inability of food to pass through the esophagus and into the stomach, causing difficulty swallowing.
Do Not Miss Diagnoses
- Esophageal Cancer: Although less common, esophageal cancer can present with difficulty swallowing and is critical to diagnose early due to its poor prognosis if left untreated.
- Stroke or Other Neurological Disorders: Conditions affecting the brain or nervous system can impair the swallowing mechanism, leading to dysphagia. Early recognition is crucial for appropriate management and prevention of complications like aspiration pneumonia.
Rare Diagnoses
- Eosinophilic Esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant, leading to difficulty swallowing.
- Scleroderma: A chronic disease characterized by deposition of collagen, replacing normal tissue, which can affect the esophagus and cause dysphagia among other symptoms.
- Zenker's Diverticulum: A condition where a pouch forms in the pharynx, which can trap food and cause difficulty swallowing, regurgitation of food, and aspiration.