Dysphagia for the acute physician

Dysphagia (subjective difficulty in swallowing) is a common clinical problem, particularly in the elderly population. Ideally, patients should be assessed promptly in the appropriate outpatient setting, but frequently they will be admitted on an acute medical take due to ‘total’ dysphagia, dehydration, debilitation or possible aspiration. A careful history and examination can usually elucidate the site of the lesion and its possible cause, and thus direct initial management. This article will concentrate on the role of the acute physician in the assessment of patients with dysphagia within the first 48 hours of presentation.