Esophageal Dysphagia Diagnostic Tools

Diagnostic Tools for Esophageal Dysphagia

Esophagram (Barium Swallow Study)

 

Double-contrast esophagram is usually the first specific diagnostic test in the evaluation of esophageal dysphagia.

It can detect subtle narrowing or esophageal webs that may not be evident with endoscopy.

Endoscopy

This is the procedure of choice to evaluate the mucosa of the esophagus.  It is used to detect structural abnormalities.  Flexible endoscopy is used by gastroenterologists.  It allows the insufflation of air to distend the esophagus and more easily see all of the mucosa.  The GI can get a magnified view, suction and biopsy portions of the esophageal mucosa.

Rigid Esophagoscopy

This is used by otolaryngologists and requires general anesthesia.  It examines the full extent of the esophagus, but does not use a magnified view and the esophagus is not distended.

Transnasal Esophagoscopy

This procedure uses topical anethesia only and allows insufflation of air to distend the esophagus and more easily see all of the mucosa. The patient is asked to swallow as the scope is passed through the upper esophageal sphincter.  Air is then insufflated through the esophagus.  If mucosal irregularities or lesions are found, multiple biopsies are taken with biopsy forceps.

 

Esophageal Manometry

 

Esophageal manometry measures intraluminal presures of the UES, esophageal body, and LES, It also measures the strength, timing and sequencing of pressure events.  It is indicated for patients who need recurrent intraluminal pressure assessment such as for alchalasia and diffuse esophageal spasms.

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Tags: dysphagia, endoscopy, esophageal disorders, esophageal manometry, esophagram, rigid ensophagoscopy