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June 14, 1976

Pharyngeal and Upper Esophageal Dysphagia

Author Affiliations

From the Department of Radiology, College of Physicians and Surgeons, Columbia University, and Columbia-Presbyterian Medical Center, New York.

JAMA. 1976;235(24):2643-2646. doi:10.1001/jama.1976.03260500051035

"DYSPHAGIA" means difficulty in the transport of swallowed material from the mouth through the pharynx and esophagus into the stomach. True dysphagia does not imply pain but the awareness that something has lodged in the pharynx or esophagus, although this may be accompanied by some discomfort. Clinically, it may be acute or chronic and localized in the upper or lower esophagus. The patient can usually localize the site of obstruction with reasonable accuracy, although occasionally the sensation of dysphagia may be referred from the distal part of the esophagus to the region of the suprasternal notch or pharynx. If a balloon is distended in the distal part of the esophagus, induction of the sensation to the suprasternal notch occurs in about 10% of subjects.

The type of food that causes the dysphagia may be a helpful clue to its origin. Bones from meat, fowl, or fish, or a large bolus