CLINICAL DIAGNOSTIC MANUAL
Dysphagia for solids that do not get stuck and progresses to dysphagia for liquids is a progressive condition indicating a gradual decline in swallowing ability. This impairment can be caused by both mechanical and functional problems affecting the pharynx and oesophagus.
Initially, the patient may experience difficulty swallowing solid foods, which eventually extends to liquids. This progressive pattern of dysphagia requires a thorough evaluation to identify the underlying cause and provide appropriate treatment.
Pathology | Symptoms and Clinical Signs | Suspected Diagnosis | Confirmatory Diagnosis |
Globus pharyngeus | Persistent sensation of a lump in the throat, without actual difficulty swallowing, often worsened by stress | Medical history, physical examination, psychological symptoms | Clinical evaluation, exclusion of other causes, endoscopy |
Xerostomia | Dry mouth, difficulty swallowing dry foods, dental caries, oral infections | History of dryness symptoms, physical examination | Salivary function tests, serology for Sjögren’s syndrome, sialography |
Pharyngeal pouch (Zenker’s diverticulum) | Regurgitation of undigested food, halitosis, dysphagia, cough, sensation of a foreign body in the throat | Medical history, physical examination | Contrast oesophagram, endoscopy |
Post-cricoid web | Progressive dysphagia for solids and liquids, iron-deficiency anaemia, fatigue | Medical history, physical examination | Oesophageal endoscopy, contrast oesophagram |
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