Zahra Nazish, Muhammad Inayatullah, Muhammad Younus Khan.
Etiology of dysphagia; based on upper gi endoscopy.
Professional Med J Jan ;23(09):1039-44.

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.

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