Differential Diagnosis for Intermittent Painful Dysphagia
Single Most Likely Diagnosis
- Esophageal Spasm: This condition is characterized by abnormal muscle contractions of the esophagus, which can cause intermittent painful dysphagia. The pain is often chest pain that can be severe and may radiate to the back, arm, or jaw.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause dysphagia due to chronic inflammation and scarring of the esophagus, leading to intermittent painful swallowing.
- Esophagitis: Inflammation of the esophagus, often due to acid reflux or infection, can cause painful dysphagia.
- 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 inflammation and painful swallowing.
Do Not Miss Diagnoses
- Esophageal Cancer: Although less common, esophageal cancer can cause painful dysphagia and is critical to diagnose early for effective treatment.
- Achalasia: A rare disorder of the esophagus that makes swallowing difficult, leading to dysphagia. It can be painful and is important not to miss due to its impact on quality of life and potential for complications.
- Foreign Body Obstruction: Especially in children or adults with certain risk factors, an object lodged in the esophagus can cause sudden onset of painful dysphagia.
Rare Diagnoses
- Scleroderma: A chronic disease characterized by deposition of collagen, replacing normal tissue, which can lead to esophageal dysmotility and painful dysphagia.
- Chagas Disease: Caused by a parasite, it can lead to destruction of the myenteric plexus of the esophagus, resulting in dysphagia.
- Esophageal Ring or Web: Abnormal, ring-like structures that can partially block the esophagus, causing intermittent dysphagia, which may be painful.