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Published in Gastroenterology

Expert Opinion / My Approach · March 31, 2015

MY APPROACH to Endoscopy-Negative Dysphagia

Written by
Benjamin Cassell MD
Gregory S. Sayuk MD, MPH


Additional Info

  1. Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. Dysphagia. 1991;6(4):187-192.

  2. Cho SY, Choung RS, Saito YA, et al. Prevalence and risk factors for dysphagia: a USA community study. Neurogastroenterol Motil. 2015;27(2):212-219.
  3. Spechler SJ. AGA technical review on treatment of patients with dysphagia caused by benign disorders of the distal esophagus. Gastroenterology. 1999;117(1):233-254.

  4. ASGE Standards of Practice Committee, Pasha SF, Acosta RD, Chandrasekhara V, et al. The role of endoscopy in the evaluation and management of dysphagia. Gastrointest Endosc. 2014;79(2):191-201.
  5. Kahrilas PJ, Smout AJ. Esophageal disorders. Am J Gastroenterol. 2010;105(4):747-756.
  6. Varadarajulu S, Eloubeidi MA, Patel RS, et al. The yield and the predictors of esophageal pathology when upper endoscopy is used for the initial evaluation of dysphagia. Gastrointest Endosc. 2005;61(7):804-808.
  7. Esfandyari T, Potter JW, Vaezi MF. Dysphagia: a cost analysis of the diagnostic approach. Am J Gastroenterol. 2002;97(11):2733-2737.
  8. Gentile N, Katzka D, Ravi K, et al. Oesophageal narrowing is common and frequently under-appreciated at endoscopy in patients with oesophageal eosinophilia. Aliment Pharmacol Ther. 2014;40(11-12):1333-1340.
  9. Kim HP, Vance RB, Shaheen NJ, Dellon ES. The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10(9):988-996 e5.
  10. Halpert RD, Feczko PJ, Spickler EM, Ackerman LV. Radiological assessment of dysphagia with endoscopic correlation. Radiology. 1985;157(3):599-602.
  11. Ott DJ, Gelfand DW, Wu WC, Chen YM. Radiological evaluation of dysphagia. JAMA. 1986;256(19):2718-2721.
  12. Conchillo JM, Nguyen NQ, Samsom M, et al. Multichannel intraluminal impedance monitoring in the evaluation of patients with non-obstructive Dysphagia. Am J Gastroenterol. 2005;100(12):2624-2632.
  13. Olson JS, Lieberman DA, Sonnenberg A. Empiric dilation in non-obstructive dysphagia. Dig Dis Sci. 2008;53(5):1192-1197.
  14. Colon VJ, Young MA, Ramirez FC. The short- and long-term efficacy of empirical esophageal dilation in patients with nonobstructive dysphagia: a prospective, randomized study. Am J Gastroenterol. 2000;95(4):910-913.
  15. Scolapio JS, Gostout CJ, Schroeder KW, et al. Dysphagia without endoscopically evident disease: to dilate or not? Am J Gastroenterol. 2001;96(2):327-330.
  16. Lavu K, Mathew TP, Minocha A. Effectiveness of esophageal dilation in relieving nonobstructive esophageal dysphagia and improving quality of life. South Med J. 2004;97(2):137-140.
  17. Deschner WK, Maher KA, Cattau EL, Benjamin SB. Manometric responses to balloon distention in patients with nonobstructive dysphagia. Gastroenterology. 1989;97(5):1181-1185.

  18. Weijenborg PW, de Schepper HS, Smout AJ, Bredenoord AJ. Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: A Systematic Review. Clin Gastroenterol Hepatol. 2015;13(2):251-259.e1
  19. Amarasinghe G, Sifrim D. Functional esophageal disorders: pharmacological options. Drugs. 2014;74(12):1335-1344.
  20. Galmiche JP, Clouse RE, Balint A, et al. Functional esophageal disorders. Gastroenterology. 2006;130(5):1459-1465.

Further Reading