ETIOLOGY OF DYSPHAGIA

Objectives: To determine the etiology of dysphagia based on upper GI endoscopyin 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 toAugust 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 patientswas 44.37±17.395 years. Most common finding was benign stricture (28.5% cases) followedby no abnormality (21.7%), carcinoma esophagus (20.7%), achalasia (6.5%), esophagealweb (4%), ulcers (3.7%), multiple pathologies (3.1%), pharyngeal cancer (2.2%), esophagealcandidiasis (1.9%), reflux esophagitis (1.5%) and hiatus hernia (1.2%). Uncommon findingswere 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 theinvestigation of choice for patients of dysphagia. Most common finding in our study was benignstricture in young females, followed by carcinoma esophagus, achalasia, web, ulcer, pharyngealcancer, 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 toavoid the preventable causes by patient awareness and adequate treatment of predisposingfactors.