Differential Diagnosis for Dysphagia
The differential diagnosis for dysphagia can be organized into the following categories:
- Single Most Likely Diagnosis
- Gastroesophageal reflux disease (GERD): This is often the most common cause of dysphagia, particularly in patients with a history of heartburn or regurgitation. GERD can cause inflammation and scarring in the esophagus, leading to difficulty swallowing.
- Other Likely Diagnoses
- Esophageal stricture: A narrowing of the esophagus, often caused by chronic inflammation or scarring, which can lead to dysphagia.
- Esophagitis: Inflammation of the esophagus, often caused by acid reflux, infections, or allergies, which can cause difficulty swallowing.
- Achalasia: A rare disorder of the esophagus that makes swallowing difficult, caused by abnormal muscle contractions.
- Diffuse esophageal spasm: A condition characterized by abnormal muscle contractions in the esophagus, which can cause dysphagia.
- Do Not Miss Diagnoses
- Esophageal cancer: Although less common, esophageal cancer can cause dysphagia and is a critical diagnosis to consider, as early detection and treatment can significantly improve outcomes.
- Pill esophagitis: Caused by certain medications, such as antibiotics or bisphosphonates, which can cause inflammation and scarring in the esophagus.
- Eosinophilic esophagitis: A chronic inflammatory condition of the esophagus, often caused by allergies or acid reflux, which can cause dysphagia and is important to diagnose to prevent long-term complications.
- Rare Diagnoses
- Scleroderma: A chronic autoimmune disorder that can cause fibrosis and narrowing of the esophagus, leading to dysphagia.
- Chagas disease: A parasitic infection that can cause inflammation and scarring in the esophagus, leading to dysphagia.
- Esophageal web: A rare condition characterized by a thin, membranous tissue that obstructs the esophagus, causing dysphagia.
- Zenker's diverticulum: A rare condition where a pouch forms in the pharynx, which can cause dysphagia and regurgitation of food.