Dysphagia and Odynophagia in a Woman With Hypothyroidism

Xiang Liu, MD; John W. Birk, MD


May 03, 2023

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.


A 55-year-old woman with hypothyroidism who is otherwise healthy presents with dysphagia and odynophagia. During the past year, she has had a sensation of food being stuck in her chest, which is accompanied by pain. Her symptoms are progressively worsening, with intolerance to both solids and liquids. Liquids are somewhat easier to tolerate than are solids and do not cause as much pain.

She does not report nausea, vomiting, regurgitation, abdominal pain, weight loss, and rash. She has no personal history of acid reflux, food impaction, caustic ingestion, or esophageal disease as well as no family history of esophageal disease or cancer. Her only medication is levothyroxine.

The patient does not smoke, drink alcohol, or use illicit drugs. She has no prior occupational exposures.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.