Dysphagia

Dysphagia refers to difficulty swallowing, whether or not it's solids, liquids, or bad news. Dysphagia differs from odynophagia and globus. Don't ask us how or why, just trust us on this.

Classifications

Dysphagia can further by classified by the likely anatomic source:

Oropharyngeal dysphagia - Difficulty with the initiation of a swallow, as is common in interns suffering from foot-in-mouth disease.^[1]
Esophageal dysphagia - Difficulty swallowing several seconds after initiating a swallow, as is common in interns suffering from foot-in-mouth disease whose shoe actually got lodged into the esophagus.
Gastric dysphagia - Difficulty swallowing originating from the stomach because the intern's shoe is tickling the pylorus.
Intestinal dysphagia - Difficult swallowing originating from the small or large intestines since intern's said shoe is now close to causing a bowel obstruction.^[2]
Anal dysphagia - Difficulty swallowing originating from the anus, not from the intern's shoe, but from an attending or nursing kicking the intern in the butt and getting his or her shoe stuck in the intern's rectum.

Evaluation

History - Overrated. Skip it.

Diagnostic testing - There are several kinds:

Barium swallow - This procedure is performed by radiologists to rule out an obstructive lesion and make money.
Upper endoscopy - This is performed by a gastroenterologist, who uses an endoscope to collect specimens and money.
Motility testing - This is performed by PT and OT to make money.

Differential Diagnosis

There are several causes of dysphagia, assuming it's not related to an intern's shoe: