Abstract
Background: There is scarcity of data on the etiological spectrum of dysphagia from India. The
study was conducted to determine the etiological spectrum of dysphagia in coastal
Odisha.
Materials and Methods: Consecutive patients presenting with dysphagia to the gastroenterology outpatient
department in 2017 were studied. Patients were evaluated with meticulous history,
clinical examination, esophagogastroduodenoscopy, and chest X-ray. Barium study and
endoscopic biopsy were done when necessary.
Results: Of 216 consecutive patients, 122 (56.48%) were male and 94 (43.52%) were female with
a mean age of 42.3 ± 17.4 years. The common etiologies were benign stricture in 68
(31.48%) and esophageal carcinoma in 51 (23.62%). Other etiologies included achalasia
cardia in 11 (5.09%), esophageal candidiasis in 10 (4.63%), pharyngeal cancer in 4
(1.85%), and esophageal web in 3 (1.39%). In 63 (29.17%) cases, no etiology was detected.
Most of the benign strictures were due to corrosive injury in 48 (70.59%); other causes
included peptic stricture (8, 11.76%), postsurgery (4, 5.88%), sclerotherapy-induced
stricture (2, 2.94%), and pill-induced stricture (2, 2.94%); in 4 (5.88%) cases, the
cause of stricture was not known. The most common cause of corrosive injury was acid
injury in 38 (79.17%), followed by alkali injury in 4 (8.34%). In 6 (12.5%) cases,
the nature of corrosive was not known. Most of the corrosive injuries were due to
suicidal intake.
Conclusion: In this study, the most common cause of dysphagia was benign corrosive stricture
due to suicidal intake of corrosives. Esophageal carcinoma, achalasia cardia, and
esophageal candidiasis were other significant etiologies. Uncommon causes of dysphagia
included esophageal web, pharyngeal cancer, and reflux esophagitis.
Keywords
barium study - benign stricture - corrosive injury - esophagogastroduodenoscopy
