Version July 2025
| Do you have problems initiating a swallow or do you feel food getting stuck a few seconds after swallowing? (Helps distinguish oropharyngeal from esophageal dysphagia.) |
| Do you cough or choke or is food coming back through your nose after swallowing? (These symptoms suggest oropharyngeal dysphagia.) |
| Do you have problems swallowing solids, liquids, or both? (Liquids, not solids, suggests a functional disorder; solids alone or progressing later to include liquids suggests a benign or malignant obstruction.) |
| How long have you had problems swallowing and have your symptoms progressed, remained stable, or are they intermittent? (Rapidly progressive dysphagia is concerning for malignancy.) |
| Could you point to where you feel food is getting stuck? (Ability to localize source of esophageal dysphagia is unreliable; best with oropharyngeal dysphagia.) |
| Do you have other symptoms such as loss of appetite, weight loss, nausea, vomiting, regurgitation of food particles, heartburn, vomiting fresh or old blood, pain during swallowing, or chest pain? |
| Do you have medical problems such as diabetes mellitus, scleroderma, Sjögren's disease, overlap syndrome, HIV, neuromuscular disorders (stroke, Parkinson disease, myasthenia gravis, muscular dystrophy, multiple sclerosis), cancer, Chagas disease, or others? |
| Have you had surgery on your larynx, esophagus, stomach, or spine? |
| Have you received radiation therapy in the past? |
| What medications are you using now (ask specifically about potassium chloride, alendronate, ferrous sulfate, quinidine, ascorbic acid, tetracycline, aspirin and NSAIDs)? (Pill esophagitis can cause dysphagia.) Also ask about opioid use which can result in an esophageal motility disorder. |
