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Timely identification and referral helped to seek right treatment

Mr. Ujala, 53 years, local businessmen by profession, having difficulty swallowing food especially solids for last one year. He visited local practitioners for relief, but situation did not improve. He came to know about availability of specialist doctor Teleconsultation at Mau CHC and decided to visit.  On examination, he reported history of intermittent but progressive difficulty swallowing to both solids and liquids. He had been able to manage his symptoms by using water to flush foods and elevating the head of his bed during sleep. He did not experience choking or coughing with swallowing. Two weeks before presentation, he began to feel generally unwell, with worsening dysphagia. He describes a sensation of both solids and liquids sticking in the middle of the throat. This sensation has slowly worsened over time. He has lost 11 kg over a period of one year. 

His treatment started with medication and advised to undergo upper GI endoscopy for ruling out the cancer of aerodigestive route (which is usually the common cause of dysphagia in this age) with sonography of the neck. He reviewed after four days with the USG report (of left thyroid nodule 13*10 mm size).  His condition was stabilised with symptomatic management and doctor counselled him to visit higher medical center for further management in view of FNAC of thyroid nodule.  Timely identification and referral helped Mr. Ujala to seek right treatment for his condition.

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