Dysphagia with “normal” endoscopy

Dysphagia is a frequent trigger for gastroenterology consultation. It is rightly considered as an alarming symptom requiring endoscopy whatever its clinical presentation is. Endoscopy will allow for diagnosing oesophageal cancer, severe peptic oesophagitis, peptic stenosis and late-stage oesophageal achalasia. It is possible that endoscopy cannot pinpoint the origin of dysphagia for several reasons: the underlying cause is not in the oesophagus; endoscopic abnormalities are minimal or riot recognized, or it is an oesophageal motor disorder. The diagnostic and therapeutic management of oro-pharyngeal dysphagia will not be detailed in this article.