Dysphagia A simple rule for Dysphagia diagnosis! When a patient presents with difficulty swallowing, the history of progression can tell you a lot. Here's a quick clinical pearl to differentiate the cause: 1️⃣ SOLIDS first, then LIQUIDS? Think Mechanical Obstruction. The lumen is progressively narrowing. Top Differentials: Esophageal Stricture, Carcinoma. 2️⃣ LIQUIDS first (or both together), then SOLIDS? Think Motility Disorder. The neuromuscular coordination is the primary issue. Top Different