Pharyngoesophageal dysphagia and gastroesophageal reflux

Abstract

Pharyngoesophageal dysphagia occurred in 51.3 percent of 1,000 consecutive patients with gastroesophageal reflux. Aspiration, secondary to food obstruction, occurred in 30 percent of these patients, and some developed significant secondary respiratory symptoms. The site of obstruction was localized to the cricopharyngeus by timing the interval from swallow to obstruction. Cricopharyngeal incoordination was demonstrated in 20 of 52 patients studied by high speed esophageal manometry. Surgical correction of gastroesophageal reflux in patients with intractable reflux symptoms was shown to be effective in relieving pharyngoesophageal dysphagia in all but a small number of patients with very severe symptoms. In those with persistent dysphagia cricopharyngeal myotomy at a later stage was effective in giving relief.

Association of Laryngopharyngeal Symptoms With Gastroesophageal Reflux Disease

“…Dysphagia has been documented in more than 50% of patients with GERD as another frequent laryngopharyngeal symptom. 24 We found dysphagia in 54% of patients with GERD. Nevertheless, the symptoms dysphagia, globus sensation, hoarseness, and laryngospasm seemed not to be specific for reflux disease because the prevalence in non‐GERD patients was even higher than in patients with GERD.…”

A Retrospective Analysis of the Pharyngeal Swallow in Patients with a Clinical Diagnosis of GERD Compared with Normal Controls: A Pilot Study

“…While not extensively studied, there are some indications that people with GERD may experience some extraesophageal swallow diculties as well. Henderson et al [19] found a 51.3% occurrence of pharyngoesophageal dysphagia in a sample of 1000 consecutive re¯ux patients. Many of their patients coughed and choked with swallowing because of forward spillage of the obstructed food bolus, and some of them aspirated.…”

Pharmacological Treatment of Dysphagia in Stroke

“…It has been dem- onstrated that dihydropyridines act on the calcium channels of nonvascular smooth muscle [25] and may have a role in reducing esophageal spasm [19]. It has also been suggested that treatment of coexisting esophageal disease improves pharyngeal dysphagia, especially when these final effector pathways are intact [26]. It has also been hypothesized that nifedipine has a more global effect, enhancing overall stroke recovery including swallowing during the acute phase [25].…”