Investigating dysphagia in adults: symptoms and tests

What you need to knowNew onset dysphagia in adults requires urgent direct access upper gastrointestinal endoscopy (to be done within two weeks); dysphagia associated with head and neck cancer red flags requires a suspected head and neck cancer pathway referralIn many cases malignancy is not found, but management of benign conditions, such as oesophageal dysmotility or gastro-oesophageal reflux, can be challengingSecondary sequelae of benign and malignant dysphagia include malnutrition and aspiration pneumonia: consider early input from dietetic and speech and language therapy teamsDysphagia is a commonly encountered problem affecting one in 17 people in their lifetime.1 It describes difficulties with eating, drinking, and swallowing. In those presenting acutely or to primary care, a detailed history guides the decision about urgency, need, and nature of onward referrals. This article highlights salient points in the history and examination when a patient presents with dysphagia, preliminary investigations, and how these inform onward referral…
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