Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Other diagnostic factors

  • posturing to aid swallowing
  • retrosternal pressure/pain
  • regurgitation
  • gradual weight loss
  • heartburn
  • slow eating
  • coughing/choking while recumbent
  • recurrent chest infections
  • sensation of a lump in the throat (globus)
  • hiccups

Risk factors

  • herpes and measles viruses
  • autoimmune disease
  • HLA class II antigens
  • consanguineous parents
  • Allgrove syndrome

Diagnostic investigations

1st investigations to order

  • upper gastrointestinal endoscopy
  • barium swallow
  • oesophageal manometry
Full details

Investigations to consider

  • chest x-ray
  • radionucleotide oesophageal emptying studies
  • timed barium oesophagogram
  • CT chest
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Jin-Yong Kang

Honorary Consultant Gastroenterologist

St George's Hospital

London

UK

Disclosures

JYK declares that he has no competing interests.

Dr Jin-Yong Kang would like to gratefully acknowledge Kalliopi Alexandropoulou, a previous contributor to this topic. KA declares that she has no competing interests.

Peer reviewers VIEW ALL

Consultant Gastroenterologist

Sandwell General Hospital

West Bromwich

UK

Disclosures

NT declares that he has no competing interests.

Consultant in General Medicine

Leicester General Hospital

Leicester

UK

Disclosures

JdC declares that he has no competing interests.

Assistant Professor of Surgery

Children's Hospital of Pittsburgh

Pittsburgh

PA

Disclosures

DH declares that he has no competing interests.

Professor of Medicine

University of Connecticut Health Center

Farmington

CT

Disclosures

GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.

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