[Dysphagia] The importance of esophageal considerations

[eripley at yahoo.com (Irene Campbell-Taylor)]

Throughout the recent discussion on esophageal function, one vitally important issue has not been fully addressed.  While I appreciate Michel's position, it must be recognized that whoever is first in line to examine the patient has to be the one to consider that there may be a life threatening issue at hand, one that I have encountered far too often.  That is the patient who complains of an oropharyngeal problem (e.g. globus sensation), is dismissed as not having one but in fact has an esophageal carcinoma. A few weeks ago I saw a gentleman about a neck injury - not for dysphagia- and something he mentioned just in passing raised a red flag. I wrote to his family physician suggesting a gastroendoscopy.  The gentleman had a large esophageal adenocarcinoma, previously unsuspected, immediately operated on, outcome, of course, unknown. This is the specter that always raises its head, especially since esophageal adenocarcinoma is the most prevalent cancer in western society.
 The influence and function of the esophagus must always be taken into consideration for this reason if for no other.

Dr I Campbell-Taylor
Clinical Neuroscientist
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