D. Oesophageal candidiasis – Explanation
Pain on swallowing (odynophagia) is a typical of oesophageal candidiasis, a well documented
complication of inhaled steroid therapy
Dysphagia
The table below gives characteristic exam question features for conditions causing dysphagia:
| Oesophageal cancer |
Dysphagia may be associated with weight loss, anorexia or vomiting during eating Past history may include Barrett’s oesophagus, GORD, excessive smoking or alcohol us |
| Oesophagitis | May be history of heartburn
Odynophagia but no weight loss and systemically well |
| Oesophageal candidiasis |
There may be a history of HIV or other risk factors such as steroid inhaler use |
| Achalasia | Dysphagia of both liquids and solids from the start
Heartburn |
| Pharyngeal pouch |
More common in older men Represents a posteromedial herniation between thyropharyngeus and cricopharyngeus muscles Usually not seen but if large then a midline lump in the neck that gurgles on palpation Typical symptoms are dysphagia, regurgitation, aspiration and chronic cough. Halitosis may occasionally be seen |
| Systemic sclerosis |
Other features of CREST syndrome may be present, namely Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia |
| Myasthenia gravis |
Other symptoms may include extraocular muscle weakness or ptosis Dysphagia with liquids as well as solids |
| Globus hystericus |
May be history of anxiety Symptoms are often intermittent |
