Virtual Clinic – Patient with intermittent dysphagia

Virtual Clinic – Patient with intermittent dysphagia

A 34-year-old man was referred by his GP under the 2-week wait suspected cancer pathway with symptoms of dysphagia.  On further questioning he gave a 15-year history of swallowing problems and occasional heartburn.  He described intermittent dysphagia to solid foods, and occasional odynophagia after drinking orange juice. His weight is stable.  He has had a previous endoscopy 8 years ago which have been reported as normal.  He has tried PPIs over the years, but never found these to be particularly helpful.

References and recommended further reading about EoE

Attwood, S., Smyrk, T., Demeester, T., Eosophageal asthma – episodic dysphagia and eosinophilic infiltrates. Gut, 30 (10)

Attwood, S.E., 2019. Overview of eosinophilic oesophagitis. British Journal of Hospital Medicine80(3), pp.132-138.

Chen, J.W. and Kao, J.Y., 2017. Eosinophilic esophagitis: update on management and controversies. BMJ359.

Dhar, A., Haboubi, H.N., Attwood, S.E., Auth, M.K., Dunn, J.M., Sweis, R., Morris, D., Epstein, J., Novelli, M.R., Hunter, H. and Cordell, A., 2022. British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults. Gut.

Philpott, H., Nandurkar, S., Royce, S.G., Thien, F. and Gibson, P.R., 2016. A prospective open clinical trial of a proton pump inhibitor, elimination diet and/or budesonide for eosinophilic oesophagitis. Alimentary Pharmacology & Therapeutics43(9), pp.985-993.

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