Cricopharyngeal Dysfunction

What Is Cricopharyngeal Dysfunction?

Cricopharyngeal dysfunction or spasms occur when the cricopharyngeus muscle around the esophagus cannot relax, preventing food from entering the esophagus properly.

Causes of Cricopharyngeal Dysfunction

Cricopharyngeal dysfunction can be caused by esophageal muscle enlargement, changes in the nerve signaling pathways, scarring of the muscle, radiation, trauma, stroke, or gastroesophageal reflux disease (GERD).

What Are the Symptoms of Cricopharyngeal Dysfunction?

A person with cricopharyngeal dysfunction may experience:

• The feeling that food is stuck in the back of the throat (or lump in the throat)
• Difficulty swallowing
• Coughing or choking when eating or drinking
• Regurgitation of food or drink
• Inability to swallow large pieces of food

Diagnosing Cricopharyngeal Dysfunction

The Penn Center for Voice, Speech and Swallowing specialists will begin by reviewing your symptoms and medical history.

If cricopharyngeal dysfunction is suspected, a diagnostic endoscopy will be performed. This is an outpatient procedure that takes less than 5 minutes and is performed with local anesthetic.

An X-ray swallowing test called a modified barium swallow may also be used. During this study, you will swallow various barium-coated food, liquid, and pills. X-ray video is taken simultaneously to see how your esophagus works.

Cricopharyngeal Dysfunction Treatment

Swallowing therapy specialists at the Penn Center for Voice, Speech and Swallowing offer the full range of treatments available for cricopharyngeal dysfunction. If changes to your diet or lifestyle don't help manage your condition, your doctor may suggest one of the following:

• Botox injections to provide temporary relief of symptoms by "paralyzing" the muscle.
• Medication for acid reflux
• Balloon dilation is a minimally invasive procedure that is used to stretch the muscle and allow food and liquid to pass through. This is performed with a catheter that is passed through the mouth and into the esophagus. A balloon at the end of the catheter is inflated to enlarge the opening. This procedure can significantly improve symptoms for about 6 months. It can be repeated as needed.
• Cricopharyngeal myotomy is a surgery that can be performed using either an endoscopic or open approach through the mouth or a small incision on the neck. During this surgery, the cricopharyngeal muscle is cut to release its "grip" and relieve symptoms.

Penn Programs & Services for Cricopharyngeal Dysfunction