Role of Endoscopy in the Evaluation and Management of Dysphagia
Publication Date: December 13, 2013
Last Updated: March 14, 2022
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
American Society for Gastrointestinal Endoscopy
Publication Month/Year
December 13, 2013
Last Updated Month/Year
June 26, 2023
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