Number of Gastrointestinal Symptoms is a Useful Means of Identifying Patients with Cancer for Dysphagia.
Dysphagia is a symptom suggestive of severe underlying pathology, although its causes include organic and non-organic disorders. The epidemiology of dysphagia is, however, poorly understood. We evaluated the prevalence of dysphagia in outpatients in Japan, measured the proportion ultimately found to have an organic cause, and recorded the nature of their symptoms and the underlying disorder. Of 5362 consecutive outpatients attending the Digestive Center at our hospital between June 1, 2010 and December 31, 2012, 186 patients (3.5 %) had dysphagia with a frequency score of ≥5 out of 6. The most common diagnosis was cancer (34 patients, 18.3 %), followed by gastroesophageal reflux disease (24 patients, 12.9 %). An esophageal motility disorder was diagnosed in 21 patients (11.3 %); the causes in the remaining 107 patients (57.5 %) were miscellaneous. Multivariable analysis identified the following predictors of cancer: age ≥ 54 years, weight loss, being a drinker of alcohol, and ≤2 gastrointestinal symptoms. Our findings can be used to inform the prioritization of referrals from primary care for investigation and treatment for patients with cancer for dysphagia.
Department of General Medicine, Kawasaki Medical School, Kurashiki, Japan.
Machi
M
Tsukamoto
Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, 701-0192, Japan. n_manabe@hkg.odn.ne.jp.
Noriaki
N
Manabe
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Japan.
Tomoari
T
Kamada
Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
Toshihiro
T
Hirai
Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
Jiro
J
Hata
Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan.
Ken
K
Haruma
Department of General Medicine, Kawasaki Medical School, Kurashiki, Japan.
Kazuhiko
K
Inoue
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D015154:Esophageal Motility Disorders / Q000150:complications; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D041981:Gastrointestinal Tract / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications / Q000503:physiopathology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
Cancer; Deglutition; Deglutition disorders; Dysphagia; Gastrointestinal symptom; Number of gastrointestinal symptoms