Dysphagia is a common symptom with a broad differential diagnosis encompassing structural, inflammatory, infectious, functional, neurological, and oesophageal motility disorders. Despite major advances in endoscopy, high-resolution manometry (HRM), impedance planimetry (EndoFLIP), and swallowing assessment, diagnostic delays and inappropriate management remain common. In most cases, these shortcomings reflect errors in clinical reasoning rather than limitations of available investigations.1
Increasing recognition of eosinophilic oesophagitis (EoE), functional dysphagia, opioid-induced oesophageal dysfunction, and complex motility disorders has further emphasised the importance of integrating clinical history with endoscopic, histological, physiological, and complementary radiological findings. Optimal evaluation increasingly requires multidisciplinary collaboration involving gastroenterologists, otolaryngologists, neurologists, speech–language pathologists, radiologists, and surgeons.1–5
In this article, we discuss the most common mistakes in the evaluation and management of dysphagia and provide practical, evidence-based recommendations to help clinicians avoid them.
Dysphagia is a common symptom with a broad differential diagnosis encompassing structural, inflammatory, infectious, functional, neurological, and oesophageal motility disorders. Despite major advances in endoscopy, high-resolution manometry (HRM), impedance planimetry (EndoFLIP), and swallowing assessment, diagnostic delays and inappropriate management remain common. In most cases, these shortcomings reflect errors in clinical reasoning rather than limitations of available investigations.1
Increasing recognition of eosinophilic oesophagitis (EoE), functional dysphagia, opioid-induced oesophageal dysfunction, and complex motility disorders has further emphasised the importance of integrating clinical history with endoscopic, histological, physiological, and complementary radiological findings. Optimal evaluation increasingly requires multidisciplinary collaboration involving gastroenterologists, otolaryngologists, neurologists, speech–language pathologists, radiologists, and surgeons.1–5
In this article, we discuss the most common mistakes in the evaluation and management of dysphagia and provide practical, evidence-based recommendations to help clinicians avoid them.