Differential Diagnosis for Dysphagia, Long Standing GORD, and Chest Pain Relieved by Eructation and Belching
Single Most Likely Diagnosis
- D. Sliding hiatal hernia: This condition is closely associated with long-standing GORD (gastroesophageal reflux disease) and can cause dysphagia and chest pain, which are relieved by eructation and belching due to the temporary reduction of pressure on the esophagus and stomach.
Other Likely Diagnoses
- A. Barrett’s esophagus: While primarily associated with chronic reflux and an increased risk of esophageal adenocarcinoma, Barrett's esophagus might not directly cause the symptoms described but is a complication of long-standing GORD.
- C. Achalasia: This motility disorder of the esophagus can cause dysphagia and chest pain, and while it doesn't typically present with relief after belching, it's a consideration in the differential for dysphagia.
Do Not Miss Diagnoses
- B. Gastric volvulus: Although less common, gastric volvulus can present with severe chest pain and dysphagia, and while the relief with belching is not a classic symptom, missing this diagnosis could lead to severe complications, including gastric ischemia.
Rare Diagnoses
- Other rare conditions such as esophageal spasm or diffuse esophageal spasm could potentially cause chest pain and dysphagia, but these are less directly linked to long-standing GORD and the specific pattern of relief with eructation and belching.