Dyphagia is a disorder of swallowing. It actually occurs in up to 10% of adults older than 50 years old. How can you determine the most likely causes for dysphagia? The secret is to obtain a thorough history and using the algorithm below, which I find really helpful from a review article in American Family Physician.
How do you read the figure?
Determine first if patient has oropharyngeal vs esophageal dysphagia.
Determine if mechanical (problem is solid foods only) vs neuromuscular (problem with liquids and solids)is more likely.
Medications can cause dysphagia from esophageal mucosal injury or reduced lower esophageal sphincter tone.
CVA is most common cause of oropharyngeal dysphagia
Consider esophageal pH probe, manometry
(click image to zoom in)
Feel free to download this card and print on a 4'' x 6'' index card.