Differential Diagnosis
- Single most likely diagnosis
- Esophageal stricture: The patient's history of esophageal ulceration and current symptoms of food sticking in the esophagus suggest a possible stricture, which is a narrowing of the esophagus that can cause dysphagia.
- Other Likely diagnoses
- Gastroesophageal reflux disease (GERD): Although the patient denies burning in the chest, GERD can cause a variety of symptoms, including dysphagia and pressure under the sternum.
- Esophageal dysmotility: The patient's symptoms of food sticking in the esophagus and pressure under the sternum could be related to abnormal esophageal motility.
- Eosinophilic esophagitis: This condition can cause dysphagia, food impaction, and chest pain, and is more common in young adults.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Esophageal cancer: Although the patient is young, esophageal cancer can occur at any age, and a history of esophageal ulceration is a risk factor.
- Achalasia: This rare condition can cause dysphagia, regurgitation, and chest pain, and can be associated with an increased risk of esophageal cancer.
- Rare diagnoses
- Esophageal ring or web: These are rare conditions that can cause dysphagia and food impaction.
- Scleroderma: This autoimmune disease can cause esophageal dysmotility and dysphagia, although it is a rare condition.
- Chagas disease: This parasitic infection can cause esophageal dysmotility and dysphagia, although it is rare in the United States.