Dysphagia means difficulty swallowing. For this diagnosis it is critical that related symptoms be associated with the act of swallowing of a liquid or solid bolus. When unassociated with swallowing, the sensation of fullness in the upper esophagus suggests globus hystericus, which is distinct from dysphagia. Globus hystericus is often a sign of a functional disorder, but it may also represent an abnormality of the pharyngeal or upper esophageal musculature.
Unlike many symptoms, such as chest pain or gastrointestinal bleeding, which may be associated with esophageal disease, dysphagia specifically ascribes the problem to the esophagus. Causes of dysphagia basically fall into two groups: obstructive lesions and motor disorders. A more specific classification categorizes the cause of dysphagia according to location: preesophageal or oropharyngeal dysphagia, esophageal or transport dysphagia, postesophageal or esophagogastric dysphagia, and paraesophageal or extrinsic dysphagia. Although useful for classification, there is overlap between these categories.
Copyright © 1990, Butterworth Publishers, a division of Reed Publishing.