Role of barium esophagography in evaluating dysphagia

Patients with dysphagia can initially undergo either endoscopic or radiologic evaluation, depending on the clinical history and physician preference. We usually recommend that most patients with dysphagia initially undergo barium esophagography, and in this paper we discuss its role in evaluating dysphagia. KEY POINTS Dysphagia can be due to problems in the oropharynx and cervical esophagus or in the distal esophagus. KEY POINTS Radiologic evaluation of dysphagia has distinct advantages over endoscopy, including its ability to diagnose both structural changes and motility disorders. KEY POINTS A barium evaluation can include a modified barium-swallowing study to evaluate the oropharynx, barium esophagography to evaluate the esophagus, and a timed study to evaluate esophageal emptying. KEY POINTS Often, the true cause of dysphagia is best approached with a combination of radiographic and endoscopic studies.