First AD

Second AD

A 35-year-old man presents with a 1-year history of intermittent dysphagia to solids. He is now worried about eating in restaurants for fear of food getting stuck in his esophagus. He occasionally takes an over-the-counter acid suppressant, which provides some symptom relief.

The two most likey causes of dysphagia in this patient are eosinophilic esophagitis and Schatzki ring. Both of these can be diagnosed with upper endoscopy and dilation can also be performed if needed. A barium esophagram is an excellent method to diagnosis a Schatzki ring; however, mucosal biopsies are needed to diagnosis eosinophilic esophagitis. Ambulatory pH testing is used to evaluate for GERD and manometry can detect esophageal motility disorders. Both of these tests can be considered if symptoms continue and endoscopy is unrevealing.

Gastrointestinal Disorders

Digestive Disease Week

Conference

Fear of dining outside the home brings this patient to see you. What's the best diagnostic tool?

Dysphagia to Solids: Which Study Would You Choose?