points in the history

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  • some clinical features that may be associated with dysphagia include:
    • coughing and choking while or soon after eating or drinking
    • wet sounding voice associated with eating
    • chest congestion after eating or drinking
    • slow eating
    • a single mouthful of food taken in as multiple swallows
    • extra effort while chewing or swallowing
    • tiredness while eating
    • rise of temperature thirty minutes to an hour after eating
    • weight loss
    • change in laryngeal sensation
    • food coming out of the nose
    • pain while swallowing 
    • feeling of a lump in the throat
    • recurrent pneumonia
  • the folowing specific points in the history obtained about a dysphagic patient are also diagnostically helpful:
    • regarding the swallowing of fluid:
      • if the patient can swallow fluid as quickly as usual but has difficulty with food apparently getting stuck, then suspect a stricture. It may be benign or malignant.
      • if the patient cannot swallow fluid as quickly as usual, then this suggests that there is either a motility disorder such as achalasia, a neurological disorder, or a severely narrowed oesophageal lumen
      • if the neck bulges or gurgles on drinking, then suspect a pharyngeal pouch
    • regarding the movement of swallowing
      • if constant and painful then suspect a malignant stricture
    • the rapidity of onset is important - see aetiology

Last reviewed 10/2021