progressive dysphagia

[MudPhud20XX]

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Isn't progressive dysphagia more of an indication of esophageal cancer than achlasia? Somehow FA lists "progressive dyphagia to solids and liquid" under achlasia. Can anyone clarify this?

 

[stop2stop]

So I personally really think of it as a time course/physical characteristic thing, which the question stem should hopefully be somewhat obvious about. If it's a cancer, the mass effect is obvious. As it gets bigger you're going to have dysphagia. Note though, that the mass is really going to have to get big to cause issues with liquids. In achalasia, it's more about LES tone and peristalsis, which can also get worse with time, but issues with liquids are going to be a lot more noticeable more often and sooner. Water might be able to slide by a mass (Cancer) in the esophagus, but getting through a closed LES is going to cause bigger/more noticeable problems.

Note as well that these aren't the only things on the differential here. Sometime like scleroderma can also cause "progressive dysphagia to solids and liquids" so don't just jump to something.

 

[Mad Jack]

Progressive dysphagia is a pretty extensive differential. ALS, Barret's, achalasia, CNS tumors, esophageal tumors, CREST syndrome, etc- the associated symptoms , age and demographics of the patient, and other data are what is going to limit your differential, not the progressive nature of the dysphagia.