Etiologies of Esophageal Dysphagia Vary Among Different Age Groups

Abstract

Purpose: Dysphagia is a common problem presenting to gastroenterologists. The purpose of this study was to determine if certain types of dysphagia were more prevalent in different age groups. This knowledge will serve the clinician to provide a focused evaluation when diagnosing and planning treatment strategies for the patients. Methods: Patients were stratified by age based on decade of life. Diagnoses included obstructive disorders (Schatzki Rings, strictures and tumors); Erosive (Reflux) Esophagitis, Eosinophilic Esophagitis, motility disorders, functional disorders and miscellaneous (infections, Sjogrëns, pill-induced, Scleroderma, etc.). Results: Over 600 patients were referred to our tertiary center as diagnostic dilemmas or for treatment of dysphagia. We eliminated patients with oropharyngeal dysphagia and those with radiation strictures and anastomotic strictures. Our final patient population was 488. The Table above summarizes the findings.Table. DiagnosisConclusion: 1. SR's are relatively common in all age groups but most prevalent in groups over 50. 2. STX are relatively uncommon in patients <40 but increase with each decade of life. 3. Cancers were seen with similar frequency in ages 40-79. 4. EE causes dysphagia with greatest frequency in ages 30-59. 5. EOS is most common in patients <39. 6. IE was seen throughout all groups but is more common in patients <50. 7. Motility disorders were the leading cause of dysphagia in all age groups. a. <50 mixed disorders, achalasia, primary motility disorders. b. >60 Presbyesophagus was most common. c. 50-59, all of the above.