Differential Diagnosis for Difficulty Swallowing in an Old Woman
- Single Most Likely Diagnosis
- Dysphagia due to Aging and Presbyesophagus: As people age, the esophageal muscles can weaken, leading to difficulty swallowing. This condition is common in the elderly and can be exacerbated by other age-related changes.
- Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Chronic reflux can lead to esophageal irritation and strictures, causing dysphagia.
- Stroke or Cerebrovascular Accident: A stroke can affect the brain's ability to coordinate swallowing, leading to difficulty swallowing.
- Parkinson's Disease: This neurodegenerative disorder can affect the muscles used for swallowing, leading to dysphagia.
- Esophageal Stricture: Narrowing of the esophagus due to scar tissue can cause difficulty swallowing.
- Do Not Miss Diagnoses
- Esophageal Cancer: Although less common, esophageal cancer can cause dysphagia and is critical to diagnose early.
- Pulmonary Aspiration: Difficulty swallowing can lead to aspiration of food or liquids into the lungs, which can be life-threatening.
- Medication-Induced Dysphagia: Certain medications, such as anticholinergics or narcotics, can cause dysphagia as a side effect.
- Rare Diagnoses
- Achalasia: A rare disorder of the esophagus that makes swallowing difficult.
- Scleroderma: A chronic autoimmune disease that can cause esophageal fibrosis and dysphagia.
- Myasthenia Gravis: A rare neuromuscular disorder that can affect the muscles used for swallowing.
- Esophageal Ring or Web: A rare congenital or acquired condition that can cause dysphagia.