Contribution of upper endoscopy in the exploration of dysphagia

Aims The aim of our study was to describe the epidemio-clinical and endoscopic characteristics of dysphagia, and to investigate a possible correlation between these factors and the etiology of dysphagia.

Methods This is a retrospective study collecting all patients presenting with dysphagia to the gastroenterology department of Hedi Chaker Hospital from 2020 to 2023.

Results We included 100 patients. The mean age of the patients was 58.4±17.15 years. There was a slight female predominance with a sex ratio M/F=0.92. Eighty-two patients had dysphagia to solids (82%). The remaining patients had mixed dysphagia. Associated signs were regurgitation, epigastric pain and worsening of the general well being in 14.8 and 7 patients respectively.

Endoscopic abnormalities were dominated by hiatal hernia (N=26), peptic esophagitis (PE) (N=20 ), classified according to the LOS ANGELES classification: grade A (7 cases), grade B (8 cases), grade C (3 cases) and grade D (2 cases), extrinsic compression in 3 patients, an ulcerative process in 4 patients, a schatzki ring in 5 patients and esophageal mycosis in 4 patients. Upper Endoscopy (UE) was normal in 30 patients.

In a univariate study, age (p=0.321), type of dysphagia (p=0.298) and gender (p=0.841) were independent factors for peptic esophagitis.

There was no correlation between gender and young age with schatzki ring with p=0.713 and 0.578 respectively.

Normal UE was not correlated to young age (p=0.269), gender (p=0.861) nor the type of dysphagia (p=0.733).

Conclusions Dysphagia is a frequent reason for consultation, and should always be investigated by UE. Several etiologies may be involved. Peptic esophagitis was the most frequent cause in our study. However, endoscopy can be normal, as in our case.

Publication History

Article published online:
15 April 2024