Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 9: A 65-Year-Old Male With Long-Standing Gerd Complained Of Recent Onset Of Progressive Difficulty Swallowing (Especially Solids) And Subjective Weight Loss. How Should I Evaluate The Patient? (continued)

Emmanuel C. Gorospe, MD, MPH, FACP; Kenneth K. Wang, MD, FACG, AGAF, FASGE

Dysphagia (or difficulty in swallowing) is an alarming symptom that requires further investigation. As in any case of dysphagia, the patient’s history and predisposing factors for the development of dysphagia are vital in determining the correct diagnostic algorithm. With an accurate history alone, the cause of dysphagia can be determined in up to 80% of patients.1 The initial step is to establish the patient’s type of dysphagia. This case is suggestive of an esophageal dysphagia, in contrast to an oropharyngeal dysphagia, which usually presents as difficulty in…