ETIOLOGY OF DYSPHAGIA

BASED ON UPPER GI ENDOSCOPY

Abstract

Objectives: To determine the etiology of dysphagia based on upper GI endoscopy
in Nishtar Hospital Multan. Study design: Retrospective study. Place and Duration of study:
This study was conducted at gastroenterology unit of Nishtar Hospital Multan from Feb 2013 to
August 2014. Patients and methods: Three hundred and twenty three patients, ≥ 13 years old,
who presented with history of dysphagia to the gastroenterology unit of Nishtar Hospital Multan.
Results: Out of 323 patients, 43.7% were males and 56.3% were females. Mean age of patients
was 44.37±17.395 years. Most common finding was benign stricture (28.5% cases) followed
by no abnormality (21.7%), carcinoma esophagus (20.7%), achalasia (6.5%), esophageal
web (4%), ulcers (3.7%), multiple pathologies (3.1%), pharyngeal cancer (2.2%), esophageal
candidiasis (1.9%), reflux esophagitis (1.5%) and hiatus hernia (1.2%). Uncommon findings
were incompetent LES (0.9%), extrinsic compression (0.9%), vocal cord paralysis (0.6%),
barrett’s esophagus (0.6%), herpes simplex esophagitis (0.6%), shatzki ring (0.3%), diverticulum
(0.3%) and thick aryepiglottic folds (0.3%.). Conclusion: Esophagogastroduodenoscopy is the
investigation of choice for patients of dysphagia. Most common finding in our study was benign
stricture in young females, followed by carcinoma esophagus, achalasia, web, ulcer, pharyngeal
cancer, reflux esophagitis, esophageal candidiasis and hiatus hernia. Incompetent LES,
extrinsic compression, vocal cord paralysis, barrett esophagus, herpes simplex esophagitis,
ring, diverticulum and thick aryepiglottic folds were rare causes. Measures should be taken to
avoid the preventable causes by patient awareness and adequate treatment of predisposing
factors.