Oesophageal dysphagia: Manifestations and diagnosis

Frank Zerbib, Taher Omari

    Research output: Contribution to journalReview article

    17 Citations (Scopus)

    Abstract

    Oesophageal dysphagia is a common symptom, which might be related to severe oesophageal diseases such as carcinomas. Therefore, an organic process must be ruled out in the first instance by endoscopy in all patients presenting with dysphagia symptoms. The most prevalent obstructive aetiologies are oesophageal cancer, peptic strictures and eosinophilic oesophagitis. Eosinophilic oesophagitis is one of the most common causes of dysphagia in adults and children, thus justifying the need to obtain oesophageal biopsy samples from all patients presenting with unexplained dysphagia. With the advent of standardized high-resolution manometry and specific metrics to characterize oesophageal motility, the Chicago classification has become a gold-standard algorithm for manometric diagnosis of oesophageal motor disorders. In addition, sophisticated investigations and analysis methods that combine pressure and impedance measurement are currently in development. In the future, these techniques might be able to detect subtle pressure abnormalities during bolus transport, which could further explain pathophysiology and symptoms. The degree to which novel approaches will help distinguish dysphagia caused by motor abnormalities from functional dysphagia still needs to be determined.

    Original languageEnglish
    Pages (from-to)322-331
    Number of pages10
    JournalNature Reviews Gastroenterology and Hepatology
    Volume12
    DOIs
    Publication statusPublished - 6 Jun 2015

    Keywords

    • oesophageal dsyphagia
    • endoscopy
    • Biopsy
    • gold-standard
    • integrated pressure impedance analysis
    • neuromechanical dysfunction

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