Endoscopic evaluation of dysphagia in the elderly

Area of Science:

• Gastroenterology
• Geriatric Medicine
• Diagnostic Endoscopy

Background:

• Obstructive dysphagia is a common concern in elderly patients.
• Accurate diagnosis is crucial for effective management in this population.

Purpose of the Study:

• To evaluate the utility and safety of upper gastro-intestinal endoscopy in elderly individuals presenting with suspected obstructive dysphagia.
• To determine the range of findings and the impact of endoscopic intervention.

Main Methods:

• A prospective survey of 100 consecutive endoscopies performed on elderly patients with suspected obstructive dysphagia.
• Documentation of endoscopic findings, including lesions identified and subsequent treatments initiated.

Main Results:

• Seventy-eight percent of patients had positive findings, with benign esophageal stricture being the most common diagnosis.
• Fifteen percent of patients were diagnosed with upper gastro-intestinal malignancy (12 esophageal, 3 gastric).
• Active treatments, including dilation, radiotherapy, surgery, and Celestin tube insertion, were administered based on findings.

Conclusions:

• Upper gastro-intestinal endoscopy is a safe and valuable diagnostic tool in elderly patients with dysphagia.
• The procedure often leads to positive therapeutic interventions, even in frail individuals.
• Endoscopic findings guide management, improving outcomes for conditions ranging from benign strictures to malignancies.