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afya Dysphagia

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20160425222524 Ben  
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''Oesophageal cancer''
weight loss, anorexia or vomiting during eating
Past history may include Barrett's oesophagus, GORD, excessive smoking or alcohol use

''Oesophagitis''
 ? history of heartburn
Odynophagia but no weight loss and systemically well

''Oesophageal candidiasis''
 ? history of HIV or other risk factors such as steroid inhaler use

''Achalasia''
Dysphagia of both liquids and solids from the start

''Heartburn''
Regurgitation of food - may lead to cough, aspiration pneumonia etc

''Pharyngeal pouch''
more common in older men
posteromedial herniation between thyropharyngeus and cricopharyngeus muscles
Usually not seen but if large then a midline lump in the neck that gurgles on palpation
Typically - dysphagia, regurgitation, aspiration and chronic cough. occasionally Halitosis

''Systemic sclerosis''
 part of CREST syndrome -  Calcinosis, Raynaud's phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia
As well as oesophageal dysmotility the lower oesophageal sphincter (LES) pressure is decreased. This contrasts to achalasia where the LES pressure is increased

''Myasthenia gravis''
 other symptoms may include extraocular muscle weakness or ptosis
Dysphagia with liquids as well as solids

''Globus hystericus''
May be history of anxiety
Symptoms are often intermittent and relieved by swallowing
Usually painless - the presence of pain should warrant further investigation for organic causes