ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day Two) | March 2026-Dysphagia: Diagnosis and Management

Video Transcription

Video Summary

The session reviews how to evaluate patients with dysphagia. Dysphagia means difficulty swallowing (not painful swallowing, which is odynophagia). It becomes an emergency when patients cannot manage their own secretions due to aspiration risk. Key related symptoms include reflux (typical/atypical), globus (persistent throat lump), and water brash (salty hypersalivation from reflux).<br /><br />Clinicians should use history to distinguish structural obstruction (solids/pills, intermittent, can “wash down”) from motility disorders (solids and liquids, every meal, “stacking,” regurgitation, adaptive maneuvers). Important causes include webs, diverticula, strictures (malignant/peptic/radiation/caustic), Schatzki ring, eosinophilic esophagitis, pill esophagitis, neuromuscular disease, opioid-related dysmotility, achalasia, and scleroderma. Exam may reveal poor dentition, xerostomia, oral lichen planus, tongue fasciculations, neck masses, or sclerodactyly.<br /><br />Workup generally excludes mechanical obstruction (endoscopy ± biopsy/dilation), then assesses motility (barium studies, timed barium esophagram, manometry, EndoFLIP). A case demonstrates diagnosing type II achalasia and treating the LES (Botox, dilation, Heller myotomy, POEM) with structured follow-up for reflux and effectiveness.

Asset Subtitle

Sarel Myburgh, APRN, CNP, MS, and John A. Martin, MD, FASGE

Keywords

dysphagia evaluation

esophageal obstruction vs motility disorder

achalasia type II

endoscopy and biopsy dilation

esophageal manometry and timed barium esophagram

LES therapies (Botox dilation Heller myotomy POEM)