Investigation of choice for dysphagia for solids: (A) Endoscopy, (B) X-ray chest, (C) C.T. Scan, (D) Barium swallow
Answer is A. History A detailed history is of paramount impoance. Asceain, if dysphagia is of: (a) Sudden onset: Foreign body or impaction of food on a pre-existing stricture or malignancy, neurological disorders. (b) Progressive: Malignancy. (c) Intermittent: Spasms or spasmodic episodes over an organic lesion. (d) More to liquids: Paralytic lesions. (e) More to solids and progressing even to liquids: Malignancy or stricture. (f) Intolerance to acid food or fruit juices: Ulcerative lesions. Oesophagoscopy(Endoscopic) It gives direct examination of oesophageal mucosa and permits biopsy specimens. Flexible fibreoptic or rigid scopes can be used. Ref : ENT textbook by Dhingra 6th edition Pgno : 347,348