Pre PACES Podcast #94 Dysphagia
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Aug 18, 2024 Dr Simone Lin, a gastroenterology registrar specializing in upper GI disorders with a genomics and IBD background, walks through assessing and investigating dysphagia. Short, focused segments cover red flags, distinguishing mechanical versus neuromuscular causes, key investigations like endoscopy, barium swallow and manometry, and management pathways including achalasia, strictures and nutritional support.
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Use Progression And Food Type To Triage
- Ask whether symptoms are progressive or intermittent and whether they affect solids, liquids, or both.
- Use duration and progression to distinguish likely malignant (progressive) from neuromuscular (intermittent or solids+liquids) causes.
Ask Exactly Which Foods Cause Problems
- Directly ask what foods cause difficulty: solids only suggests obstruction; solids and liquids from onset suggests motility disorder.
- Use that simple question early to guide urgent investigations.
EoE Presents In Young Atopic Patients
- Eosinophilic oesophagitis often affects young atopic patients and presents with intermittent bolus obstruction and oesophageal rings.
- Recognise the atopic history (eczema, asthma) and younger male predominance to suspect EoE.