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
- triple A (Allgrove) syndrome
Diagnostic investigations
1st investigations to order
- upper gastrointestinal endoscopy
- barium swallow
- high-resolution oesophageal manometry
Investigations to consider
- chest x-ray
- radionucleotide oesophageal emptying studies
- timed barium oesophagogram
- CT chest
Treatment algorithm
Contributors
Authors
Honorary Consultant Gastroenterologist
St George's Hospital
London
UK
Disclosures
JYK declares that he has no competing interests.
Consultant Gastroenterologist
Royal Surrey County Hospital
Guildford
Surrey
UK
Disclosures
KA 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
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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