{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Board Pearls","title":"Chapter 1, Ep 1 of 3: Dysphagia: The Algorithm","html":"","width":"100%","height":180,"duration":638,"description":"This episode reduces the entire dysphagia workup to two bedside questions, where food sticks and what sticks when, and shows why each answer selects its own test. It sorts oropharyngeal from esophageal dysphagia, maps the solids-versus-mixed and tempo patterns onto specific diagnoses, and clarifies why new dysphagia is itself an alarm symptom that mandates a scope regardless of age.\n \nTopics covered\n\nOropharyngeal versus esophageal dysphagia\nModified barium swallow with speech therapy\nEndoscopy with biopsies for solid dysphagia\nMechanical narrowing versus motility failure\nAlarm features and dysphagia\nZenker diverticulum\nAchalasia subtypes and manometry\nEsophageal cancer red flags\n \n \nKey decisions\n\nThroat-level dysphagia with airway symptoms goes to modified barium swallow with a speech therapist, not endoscopy, because that study watches the swallow and tests airway protection.\nSolids-first progressive dysphagia points to a narrowing and goes to endoscopy with biopsies; solids-and-liquids from day one points to a failed muscle wave.\nTake esophageal biopsies high and low even when the mucosa looks normal, since eosinophilic esophagitis appears normal in up to a third of cases.\nNew dysphagia is itself an alarm symptom, so scope every patient regardless of age; the over-fifty cutoff belongs to dyspepsia, not dysphagia.\nSuspect Zenker from regurgitation of old food, halitosis, and gurgling; diagnose with barium swallow and avoid leading with endoscopy to prevent pouch perforation.\nDo not go to myotomy or dilation without manometry, because achalasia type (I, II, or III) decides the procedure and a junction tumor can mimic the picture.\n \n \nThis is an AI-generated podcast, and some pronunciations may be imperfect. Thank you for your understanding, and we hope you enjoyed this content.\n \n \nStudy the full chapter on Board Pearls, with practice questions, tables and primary-guideline references: Esophageal Symptoms and Diagnostic Workup\nRead this episode:...","thumbnail_url":"https://img.transistorcdn.com/-FuAdDBcPDLhEoUmroZKtOBRvuBn_FHPpYlh41hOnU4/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9iNzlh/ZTU4Y2MzNWExMjQ5/MjA5OWMwMmI3ZTk5/NGFiZS5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}