What is the typical symptom progression in malignant esophageal strictures?

• A. Intermittent dysphagia to liquids before solids
• B. Progressive dysphagia starting with solids and advancing to liquids, with weight loss and anorexia
• C. Immediate complete obstruction
• D. Only affects older adults

Answer: (B)

The main idea is that malignant esophageal strictures cause progressive narrowing of the lumen. As the tumor grows, solids are the first to have trouble passing, so dysphagia starts with solids. Over time the obstruction worsens and liquids also become difficult, leading to dysphagia for both solids and liquids. Weight loss and anorexia are common because the cancer and reduced intake go hand in hand. This pattern fits cancer-related obstruction, unlike intermittent difficulty with liquids before solids (more typical of motility issues or benign lesions), an immediate complete blockage (not the usual gradual progression), or symptoms that merely reflect age rather than the course of the disease.