TY - JOUR
T1 - Esophageal and Oropharyngeal Dysphagia
T2 - Clinical Recommendations From the United European Gastroenterology and European Society for Neurogastroenterology and Motility
AU - Mari, Amir
AU - Calabrese, Francesco
AU - Pasta, Andrea
AU - Lorenzon, Greta
AU - Weusten, Bas
AU - Keller, Jutta
AU - Visaggi, Pierfrancesco
AU - Roman, Sabine
AU - Marabotto, Elisa
AU - Dickman, Ram
AU - Serra, Jordi
AU - De Bortoli, Nicola
AU - Iovino, Paola
AU - Pohl, Daniel
AU - Dumitrascu, Dan
AU - Ribolsi, Mentore
AU - Barber, Claudia
AU - Bor, Serhat
AU - Fox, Mark
AU - Sweiss, Rami
AU - Lorenzo-Zuniga, Vicente
AU - Akyuz, Filiz
AU - Ghisa, Matteo
AU - Celebi, Altay
AU - Shibli, Fahmi
AU - Dziewas, Rainer
AU - Kalkan, Ismail Hakkı
AU - Tack, Jan
AU - Clavé, Pere
AU - Carrion, Silvia
AU - Cheng, Ivy
AU - Tomsen, Noemi
AU - Ortega, Omar
AU - Rubio, Sergio Marin
AU - Pizzorni, Nicole
AU - Michou, Emilia
AU - Regan, Julie
AU - Hamdy, Shaheen
AU - Rommel, Nathalie
AU - Scharitzer, Martina
AU - Ekberg, Olle
AU - Schindler, Antonio
AU - Speyer, Renee
AU - Gillman, Anna
AU - Zerbib, Frank
AU - Savarino, Edoardo V.
N1 - Publisher Copyright:
© 2025 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.
PY - 2025/7
Y1 - 2025/7
N2 - Dysphagia is a prevalent symptom of the upper gastrointestinal tract causing health related consequences, impacting quality of life and is associated with global economic burden. Swallowing difficulties are classified into oropharyngeal dysphagia (OD) and esophageal dysphagia. Despite its clinical importance, dysphagia is associated with several uncertainties regarding its optimal diagnostic work-up and management, particularly, considering the progress with diagnostic modalities and technologies. A Delphi consensus was performed with experts from various disciplines who conducted a literature summary and voting process on 41 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation criteria. Consensus was reached for all the statements. The panel agreed with the definition and prevalence of esophageal and OD types. The role of endoscopy, high-resolution manometry, EndoFLIP, barium swallow and other imaging tests in evaluating esophageal dysphagia has reached overall strong agreement. Videofluoroscopic swallow study, alongside fiber-endoscopic evaluation of swallowing, as the methods of choice for the instrumental assessment of oropharyngeal dysfunction is a strong recommendation. Regarding treatment, a weak recommendation was achieved for the use of PPIs, calcium-channel blockers, nitrates, phosphodiesterase type 5 inhibitors, antidepressants or peppermint oil for the treatment of hypercontractile esophagus. A strong recommendation exists for endoscopic and surgical treatment of achalasia, while a weak recommendation is provided for other esophageal motility disorders. Regarding OD, a weak recommendation was achieved for swallow therapy, to improve swallowing mechanics, reduce symptoms, and enhance quality of life. Swallow therapy could be more effective when using validated assessment tools, consistent treatment parameters, and considering long-term follow-up. A multinational group of European experts summarized the current state of consensus on the definition, diagnosis, and management of dysphagia.
AB - Dysphagia is a prevalent symptom of the upper gastrointestinal tract causing health related consequences, impacting quality of life and is associated with global economic burden. Swallowing difficulties are classified into oropharyngeal dysphagia (OD) and esophageal dysphagia. Despite its clinical importance, dysphagia is associated with several uncertainties regarding its optimal diagnostic work-up and management, particularly, considering the progress with diagnostic modalities and technologies. A Delphi consensus was performed with experts from various disciplines who conducted a literature summary and voting process on 41 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation criteria. Consensus was reached for all the statements. The panel agreed with the definition and prevalence of esophageal and OD types. The role of endoscopy, high-resolution manometry, EndoFLIP, barium swallow and other imaging tests in evaluating esophageal dysphagia has reached overall strong agreement. Videofluoroscopic swallow study, alongside fiber-endoscopic evaluation of swallowing, as the methods of choice for the instrumental assessment of oropharyngeal dysfunction is a strong recommendation. Regarding treatment, a weak recommendation was achieved for the use of PPIs, calcium-channel blockers, nitrates, phosphodiesterase type 5 inhibitors, antidepressants or peppermint oil for the treatment of hypercontractile esophagus. A strong recommendation exists for endoscopic and surgical treatment of achalasia, while a weak recommendation is provided for other esophageal motility disorders. Regarding OD, a weak recommendation was achieved for swallow therapy, to improve swallowing mechanics, reduce symptoms, and enhance quality of life. Swallow therapy could be more effective when using validated assessment tools, consistent treatment parameters, and considering long-term follow-up. A multinational group of European experts summarized the current state of consensus on the definition, diagnosis, and management of dysphagia.
KW - Delphi consensus
KW - barium swallow
KW - diagnosis
KW - dysphagia
KW - esophageal motility disorders
KW - high resolution manometry (HRM)
KW - management
KW - oropharyngeal dysphagia
KW - workup
UR - https://www.scopus.com/pages/publications/105008687256
U2 - 10.1002/ueg2.70062
DO - 10.1002/ueg2.70062
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C2 - 40543044
AN - SCOPUS:105008687256
SN - 2050-6406
VL - 13
SP - 855
EP - 901
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 6
ER -