Dysphagia

The aim of this topic is to review the pathophysiology of dysphagia, with emphasis on reflux oesophagitis and oesophageal carcinoma.

Learning objectives

At the completion of this topic you should be able to:

  1. Describe the normal anatomy of the oesophagus and neuromuscular function during swallowing.
  2. Distinguish between dysphagia and odynophagia (pain on swallowing).
  3. List mechanical causes of dysphagia, including inflammatory conditions, other non-neoplastic strictures and malignancies.
  4. Describe neuromuscular causes of dysphagia, emphasising achalasia, diffuse oesophageal spasm and scleroderma.
  5. Discuss the pathogenesis and clinical features of reflux oesophagitis and its complications. In particular, describe the histological features of Barrett oesophagus.
  6. Describe predisposing factors and clinical features of malignant neoplasms of the oesophagus, with an emphasis on squamous cell carcinoma and adenocarcinoma.
  7. Outline the role of endoscopy and functional studies such as manometry in the investigation of oesophageal disease.

Trial exam questions:

  1. Discuss the proposed roles for the known aetiological factors in oesophageal carcinoma.
  2. Write brief notes on the pathogenesis and complications of Barrett oesophagus.

Case protocol associated with this topic - 13

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