Last updated March 15, 2022

Role of Endoscopy in the Evaluation and Management of Dysphagia

Recommendations

We recommend endoscopic dilation for patients with dysphagia secondary to benign intrinsic strictures of the esophagus. (H)
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We recommend wire-guided dilation, preferably under fluoroscopic guidance, or TTS balloon dilation for complex esophageal strictures. (M)
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We recommend antisecretory treatment in conjunction with dilation to reduce the recurrence rate of peptic strictures. (H)
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We recommend that dilation for adult patients with EoE be reserved for those who have a dominant esophageal stricture or ring and those who remain symptomatic despite medical therapy. (M)
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We suggest adjunctive treatment with corticosteroid injection into recurrent or refractory benign esophageal peptic strictures. (L)
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We suggest that esophageal stent placement be reserved for refractory esophageal strictures that do not respond to sequential dilation and/or steroid injection. (L)
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We recommend that both endoscopic and surgical treatment options for achalasia be discussed with the patient. In patients who opt for endoscopic management and are good surgical candidates, we recommend pneumatic dilation with large-caliber balloon dilators for the endoscopic treatment of achalasia. (H)
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We recommend botulinum toxin injection for endoscopic treatment of achalasia in patients who are poor candidates for surgery or pneumatic dilation. (M)
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Recommendation Grading

Overview

Title

Role of Endoscopy in the Evaluation and Management of Dysphagia

Authoring Organization

Publication Month/Year

December 13, 2013

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management

Diseases/Conditions (MeSH)

D055154 - Dysphonia

Keywords

endoscopy, dysphagia

Source Citation

Pasha, S. F., Acosta, R. D., Chandrasekhara, V., Chathadi, K. V., Decker, G. A., Early, D. S., … Cash, B. (2014). The role of endoscopy in the evaluation and management of dysphagia. Gastrointestinal Endoscopy, 79(2), 191–201. doi:10.1016/j.gie.2013.07.042