Dysphagia endoscopy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Feham Tariq, MD [3]

Endoscopy

The endoscopy findings for dysphagia are as follows:

• Middle and lower biopsies of the esophagus should be taken with the intention of excluding eosinophilic esophagitis
• Majority will be normal or demonstrates only mild erosive disease

Oropharyngeal Dysphagia

• A patient can be assessed using videoendoscopy, also known as flexible fiberoptic endoscopic examination of swallowing (FEES).
  • The scope is placed into the nose until the clinician can view the pharynx and then he or she examines the pharynx and larynx before and after swallowing.
  • During the actual swallow, the camera is blocked from viewing the anatomical structures.

• A rigid scope can be placed into the oral cavity to view the structures of the pharynx and larynx.

Esophageal Dysphagia

• If there is no suspicion of history of surgery for laryngeal or esophageal cancer, history of radiation or irritating injury, achalasia, zenker's diverticulum, endoscopy can be performed first.
• Any structural or mucosal abnormality is treated.
• A normal endoscopy should be followed by manometry; and if manometry is also normal, the diagnosis of functional dysphagia is made.

Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach. This is a complication of chronic gastroesophageal reflux disease, and can be a cause of dysphagia.