For various patients with dysphagia. distinguish the underlying cause.

Explanation:

History is extremely important in a patient with dysphagia and the  next test is Barium swallow test.

All the dysphagias described below cause dysphagia to solids first- EXCEPT ACHALASIA which first troubles with swallowing liquid.

Cancer of the esophagus, Achalasia cardia, Diffuse esophageal spasm, Stricture due to chronic reflux or due to ingestion of a corrosive.

Cancer- usually esophageal but occasionally gastric at the cardia- weight loss and poor apetite. Enlarged supraclavicular lymph node.

Achalasia- initial dysphagia to LIQUIDS, reflux of semidigested food into the mouth on recumbency, CXR with absent gastric air bubble and an air fluid level in the mediastinum

Zenker's diverticulum- Halitosis(bad breath), gurgling heard in the neck.

Peptic stricture- long history of heartburn or waterbrash.

Lye stricture- history of attempt to commit suicide.