Dysphagia for Solids that Do NOT Stick, Progressing to Dysphagia for Liquids

CLINICAL DIAGNOSIS MANUAL

Dysphagia for solids that do not stick, and later progressing to dysphagia for liquids, is a progressive condition that indicates a gradual decline in swallowing ability. This disorder can result from both mechanical and functional issues affecting the pharynx and oesophagus.

Initially, the patient may experience difficulty swallowing solid foods, and over time, this difficulty 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	Presumptive Diagnosis	Confirmatory Diagnosis
Pharyngeal Globus	Persistent sensation of a lump in the throat without actual difficulty swallowing, often exacerbated by stress	Clinical 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	Clinical history, physical examination	Barium swallow X-ray, endoscopy
Post-Cricoid Web	Progressive dysphagia for solids and liquids, iron-deficiency anaemia, fatigue	Clinical history, physical examination	Oesophageal endoscopy, barium swallow X-ray