Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a classic triad of iron deficiency anemia, dysphagia (typically for solids), and post-cricoid esophageal web. Symptoms include progressive oropharyngeal dysphagia, odynophagia, and sensation of food sticking in the upper esophagus. Associated symptoms include glossitis, angular cheilitis, and koilonychia.
Clinical Examination Findings
Physical examination reveals signs of chronic iron deficiency: pallor of conjunctiva and mucous membranes, atrophic glossitis (smooth, red tongue), angular stomatitis, and koilonychia (spoon-shaped nails). Oropharyngeal evaluation may show signs of mucosal atrophy. Cardiovascular exam may reveal a flow murmur secondary to severe anemia.
Treatment Protocol
Management involves endoscopic dilation of the esophageal web and aggressive iron supplementation (oral or intravenous) to correct underlying iron deficiency anemia. Long-term follow-up is required due to the increased risk of squamous cell carcinoma of the esophagus and pharynx. Proton pump inhibitors may be initiated if concurrent reflux is suspected.