Patients with complaints of bolus stasis in the throat (i.e., pharynx and cervical esophagus) were less accurate at localizing bolus stasis than patients with complaints in the thoracic esophagus (p < .001). This space is bounded superiorly by the inferior margin of the cricopharyngeal muscle, anteriorly by the inferior margin of the cricoid cartilage, and inferomedially by the suspensory ligament of the esophagus originating from the posterior wall of the cricoid cartilage, just before the tendon forms the longitudinal muscle of the esophagus. The lower esophageal sphincter (LES) pressure tracing is at the level of the sleeve (tracing 6). During swallowing, Zenkers diverticulum appears as a posterior bulging of the lowermost hypopharyngeal wall above an anteriorly protruding pharyngoesophageal segment (cricopharyngeal muscle; Fig. These contractions are nonperistaltic, have no known physiologic role, and are observed with increased frequency in elderly people. Careers. Hospitalization for achalasia in the United States 1997-2006. The complications of Zenkers diverticulum include bronchitis, bronchiectasis, lung abscess, diverticulitis, ulceration, fistula formation, and carcinoma. A referred earache may occur, especially when nasopharyngeal tumors block the eustachian tube. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTc0NzgzLW92ZXJ2aWV3. Share cases and questions with Physicians on Medscape consult. The lower esophageal sphincter (LES) is composed entirely of smooth muscle and maintains a steady baseline tone to prevent gastric reflux into the esophagus.
Pharyngeal Versus Esophageal Stasis: Accuracy of Symptom Localization The barium examination can also show areas behind bulky tumors that are difficult to visualize by endoscopic examination. Disruption of this highly integrated muscular motion limits delivery of food and fluid, as well as causes a bothersome sense of dysphagia and chest pain.
Patients with benign tumors of the base of the tongue may be asymptomatic or may complain of throat irritation or dysphagia. A frontal view shows loss of the normal contour of the left piriform sinus. Clinical symptoms may include dysphagia, choking, cough, hoarseness, regurgitation of undigested food, or a painless neck mass. Future research should focus on identifying symptom profiles that could lead to targeted swallowing evaluations based on patient history and complaint. Approximately 50% of patients develop cervical nodal metastases. Laryngeal involvement in neurofibromatosis (von Recklinghausens disease) is rare but usually involves the region of the arytenoid cartilage and aryepiglottic folds. This work supports a comprehensive evaluation of both the . 2009 Apr. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. Any change in the character of dysphagia or bloody discharge in a patient known to have Zenkers diverticulum should suggest a complication. 2013 Jun. Because such a strong association exists between head and neck squamous cell carcinoma and esophageal carcinoma, a major goal of a preoperative radiologic study is to rule out a synchronous primary esophageal cancer. Eckardt AJ, Eckardt VF. Achalasia is a progressive disease that requires chronic therapy. E93q">G8}wEkeW8 Radiographic findings in pharyngeal carcinoma. The cricopharyngeal muscle has no midline raphe. Influence of Thermal and Gustatory Stimulus in the Initiation of the Pharyngeal Swallow and Bolus Location Instroke. Computed tomography (CT) and MRI may occasionally reveal lesions (typically submucosal masses) that are not visible, even with modern endoscopes. ), An 80-year-old patient with dementia underwent an upper GI examination for epigastric pain. Farmer's Empowerment through knowledge management. Hoarseness. Cross-sectional imaging studies are the examinations of choice for showing spread of tumor into the submucosa, intrinsic muscles, tissues extrinsic to the pharynx, and regional lymph nodes. [QxMD MEDLINE Link]. Barium studies are contraindicated because they may exacerbate edema, triggering an episode of acute respiratory arrest. Patients with pharyngeal symptoms or a palpable neck mass may undergo pharyngoesophagography as the initial diagnostic examination. Questionable dysmorphic features, we are awaiting genetic testing results. The term comes from the oropharynx, the location in the back of the throat, and dysphagia, which means disordered swallowing. Diagnostic Accuracy of an Esophageal Screening Protocol Interpreted by the Speech-Language Pathologist. The coordination of these simultaneously contracting muscle layers produces the motility pattern known as peristalsis. However, in the setting of a normal MRI with normal motor development, other etiologies need to be explored. I am surprised there was not retrograde flow into the nasopharynx (what some describe as nasopharyngeal regurgitation), given the diffuse residue. Racial and environmental differences in the incidence of achalasia and other esophageal motility disorders might be present; however, because of the low incidence of disease and underdiagnosis in developing countries, these differences have not been demonstrated. [QxMD MEDLINE Link]. Branchial pouch sinuses arise from the tonsillar fossa (second pouch), upper anterolateral piriform fossa (third pouch), or lower anterolateral piriform sinus (fourth pouch; Fig. Gastroenterology. 2009 Aug. 21(8):796-806.
Problem-Solving: NICU Baby with pharyngeal stasis post-swallow on A laryngocele is a protrusion of ciliated pseudostratified columnar epithelium and loose areolar connective tissue arising from saccular dilation of the appendix of the laryngeal ventricle. 16-13 ). The neck of the Zenkers diverticulum can be very broad during swallowing. Advanced achalasia can lead to malnutrition, dehydration, and aspiration.
Squamous cell carcinoma of the palatine tonsil is the most common malignant tumor arising in the pharynx. Abdullah Fayyad, MD, MBBS is a member of the following medical societies: American Gastroenterological AssociationDisclosure: Nothing to disclose. MRI is the method of choice for evaluating tumors of the nasopharynx. The radiologist may be the first physician to suggest a diagnosis of pharyngeal carcinoma ( Fig. Other diseases of pharynx. Not an uncommon presentation that can go many directions as further data comes in.
what is pharyngeal stasis - jerezada.com Tumors of the epiglottis and aryepiglottic folds may also result in dysphagia, coughing, or choking because of laryngeal penetration.
what is pharyngeal stasis - lupaclass.com Enter your email address to subscribe to this blog and receive notifications of new posts by email. Occasionally, a deeply infiltrating, primarily submucosal lesion may be manifested by subtle asymmetric enlargement of the tongue base. Image courtesy of Andrew Taylor, MD, Professor, Abdominal Imaging, Department of Radiology, University of Wisconsin Medical School, Madison. J Stroke Cerebrovasc Dis. This work supports a comprehensive evaluation of both the pharynx and the esophagus for patients with complaints of bolus stasis . There are no skeletal structures in the fourth pharyngeal arch. The symptoms of pharyngeal carcinoma are nonspecific and usually of short duration (<4 months). Almost all patients (>95%) are moderate to heavy abusers of alcohol and tobacco or have a tumor related to herpes virus. Patients with small lesions are often asymptomatic but present with enlarged cervical nodes. 2015 Dec. 174(12):1629-37. Problem-Solving with Catherine: Adenoid Hypertrophy and Pediatric Dysphagia, Problem-Solving: New infant referral but limited experience, Problem-Solving with Catherine: 3-month-old with TEF and Vocal Cord Paralysis, Lifelong Learners Join Catherine in Houston, State-of-the-Art NICU Practice: Catherine Shaker and Suzanne Thoyre. Achalasia affects both sexes in equal numbers. These poorly differentiated or undifferentiated tumors spread rapidly to the entire supraglottic region and pre-epiglottic space. Lateral Pharyngeal Pouches and Diverticula, Branchial Cleft Cysts, Branchial Cleft Fistulas, and Branchial Pouch Sinuses, Lateral Cervical Esophageal Pouches and Diverticula, Lymphoid Hyperplasia of the Lingual and Palatine Tonsils, Surgery for Tongue and Oropharyngeal Cancers, Surgery for Zenkers Diverticulum and Pharyngeal Pouches. Inflammation-induced dysmotility may result in laryngeal penetration and stasis. This redundant mucosa has been termed the postcricoid defect and was previously attributed to a venous plexus in this region. [QxMD MEDLINE Link]. Tertiary contractions are simultaneous, isolated, dysfunctional contractions. 2017 Feb 1. Familial clustering is observed, but a genetic relationship is not established. what is pharyngeal stasismerino wool gloves for hunting. Only rarely is a pedunculated polypoid lesion (e.g., papilloma, fibrovascular polyp) seen. We explored four different methods, namely, the visuoperceptual Outcomes of treatment for achalasia depend on manometric subtype. However, any asymmetrically distributed coarse nodularity or mass must be viewed with suspicion. Medical team is very supportive of therapy. With severe ulceration, amputation of the uvula and tip of the epiglottis may be observed radiographically. Please confirm that you would like to log out of Medscape. 2009 Aug. 54(8):1680-5. The thyropharyngeal muscle arises from the lateral ala of the thyroid cartilage; it courses laterally and posteriorly to merge with its counterpart from the opposite side in a raphe in the posterior pharyngeal wall. 37(12):1210-9. Am J Gastroenterol. If symptoms progress, then the workup should be repeated because DES can progress to achalasia. The LES relaxes during swallows. A sensation of food getting stuck in the throat or chest or behind the breastbone (sternum) Drooling. Curr Gastroenterol Rep. 2015 Dec. 18(1):1. A person with cricopharyngeal dysfunction may experience: a feeling of having something stuck in their throat difficulty swallowing. Dysphagia,35(1), 129-132. Initial results of diagnostic endoscopy may be negative. Epub 2014 Jul 7. On lateral views, the anterior wall of the sac is anterior to the cervical esophagus, below the level of the cricopharyngeal muscle. ,885 5*9`aXq[V#F2,\CSfCE{Wg?4C+U; XS{3)3:t,F,[(gn9qEaM^&Tydqt|8e^p
3F. High-resolution manometry in clinical practice: utilizing pressure topography to classify oesophageal motility abnormalities. ENT did not find any structural issues, but his cry is described as quiet by nurses. Ectopic thyroid tissue and thyroglossal duct cysts may occur at the tongue base but are rare. Barium studies are used primarily to evaluate the symptoms of nasal regurgitation and voice changes caused by soft palate insufficiency and to rule out a synchronous esophageal tumor. The .gov means its official. being unable to chew food properly. In scleroderma, the primary defect in this systemic process is related to smooth muscle atrophy and fibrosis. These studies are especially valuable in areas of the pharynx that are difficult to evaluate by endoscopy (e.g., lower base of the tongue, valleculae, lower hypopharynx, pharyngoesophageal segment).
The value of pharyngeal scintigraphy in predicting - PubMed [High-resolution manometry of pharyngeal swallowing dynamics]. External and internal laryngoceles do not fill with barium on pharyngograms. Neck radiographs may show smooth enlargement of the epiglottis and aryepiglottic folds. The fourth pharyngeal arch forms the laryngeal cartilages, muscles of the soft palate and pharynx, part of the subclavian artery and the arch of the aorta. 2021 Dec;36(6):1063-1071. doi: 10.1007/s00455-020-10239-3. On barium studies, irregularity of the contour of Zenkers diverticulum should suggest an inflammatory or neoplastic complication.
Pharyngeal Versus Esophageal Stasis: Accuracy of Symptom - PubMed Esophageal stasis was the most common finding regardless of complaint location. The tumor-like lesions that usually involve the aryepiglottic folds are retention cysts and saccular cysts. Measurement of Pharyngeal Residue From Lateral View Videofluoroscopic Images Catriona M. Steele,a,b Melanie Peladeau-Pigeon,a Ahmed Nagy,a,c,d and Ashley A. Waitoa Purpose: The field lacks consensus about preferred metrics for capturing pharyngeal residue on videofluoroscopy. Achalasia commonly presents in the fifth decade but rarely may develop in children as well as in elderly persons. MRI brain? Manometry demonstrates diffuse esophageal spasm with simultaneous contractions of the esophagus observed throughout the tracing. You are being redirected to
surefire led conversion head; bayou club houston membership fees. Salvador R, Dubecz A, Polomsky M, et al. The cause and clinical significance of webs are controversial. When decreased base of tongue movement, impaired pharyngeal pressure generation, and presence of pharyngeal residue are noted during a VFSS, a neurologic etiology can be suspected. Disclaimer.
Measurement of Pharyngeal Residue From Lateral View Videofluoroscopic Normal manometry results show normal esophageal body peristalsis with normal lower esophageal sphincter (LES) pressure and relaxation.
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Pharyngeal recess | definition of pharyngeal recess by Medical dictionary He was eventually diagnosed with a posterior tongue tie and underwent a frenulectomy. Choking or coughing may be caused by laryngeal penetration during swallowing or aspiration of barium trapped in ulcerated tumors. 144(4):718-25; quiz e13-4.
PDF Case Report Relato de Caso electrical stimulation on deglutition after See the images below.
Pharyngeal Phase of Deglutition Flashcards | Quizlet Inflammatory disorders of the pharynx or gastroesophageal reflux can alter pharyngeal elevation, epiglottic tilt, or closure of the vocal cords and laryngeal vestibule. There appears to be a functional imbalance between excitatory and inhibitory postganglionic pathways, disrupting the coordinated components of peristalsis. However, tumor-like cysts of various histologic types are not uncommonly seen in the pharynx. ASHA / What is a swallowing disorder? Abdullah Fayyad, MD, MBBS Gastroenterology Staff, Private Practice, Digestive and Liver Disease Consultants National Library of Medicine The second branchial cleft forms the middle ear, eustachian tube, and floor of the tonsillar fossa. Lingual tonsil lymphoid hyperplasia can be coarsely nodular, asymmetrically distributed, or masslike. The LES relaxes during swallows and stays opened until the peristaltic wave travels through the LES, then contracts and redevelops resting basal tone. With severe lymphoid hyperplasia of the base of the tongue, the nodules may extend into the valleculae, along the lingual surface of the epiglottis, or even into the upper hypopharynx. The first branchial cleft forms the external auditory meatus. o Can protude into pharynx and cause pharyngeal stasis. The pathogenesis of Zenkers diverticulum is as controversial as the muscular anatomy. A recent study (22) showed that the quantification of the oral or pharyngeal stasis (defined as a residue in the oral cavity, in the pharynx during swallowing) in the videofluoroscopic assessment is limited to a subjective character. Her paper is one I reference with neonatologists and intensivists when indicated. Asymmetrical distensibility is seen as flattening of the pharyngeal contour caused by fixation of structures by infiltrating tumor or by an extrinsic mass impinging on the pharynx. Nonperistaltic isolated contractions or low-amplitude simultaneous contractions of the esophageal body may be observed. However, no studies to date have shown convincing evidence that surveillance is worthwhile. Webs are thin mucosal folds usually located along the anterior wall of the lower hypopharynx and proximal cervical esophagus. Note the "bird-beak" appearance of the lower esophageal sphincter (LES), with a dilated, barium-filled esophagus proximal to it. 16-6 ). A barium examination can also be used to rule out a second primary lesion in the esophagus. This can cause speech that is difficult to understand. official website and that any information you provide is encrypted Dis Esophagus. They are also known as Killian-Jamieson pouches or Killian-Jamieson diverticula . Zenkers diverticulum is usually found in older patients who have dysphagia, regurgitation of undigested food, halitosis, choking, hoarseness, or a neck mass. Several older northern European series showed an association of cervical esophageal webs, iron deficiency anemia, and pharyngeal or esophageal carcinoma. Results via subsequent VFSS revealed significant improvement in base of tongue movement, pharyngeal pressure generation, and pharyngeal constriction, resulting in efficient movement of the bolus through the pharynx into the esophagus, no nasopharyngeal regurgitation, no aspiration, and near resolution of his pharyngeal dysphagia. About 50% of these patients are asymptomatic and present with a neck mass caused by cervical nodal metastases.
What is vallecular pooling? Explained by Sharing Culture Barium studies of the pharynx are usually of limited value in patients with acute sore throat caused by viral, bacterial, or fungal infection. Is there any particular intervention improving pharyngeal clearance with the swallow. No nasopharyngeal regurgitation that I recall. Diagnosis of esophageal motility disorders: esophageal pressure topography vs. conventional line tracing. 57(3):683-9. 208(6):1035-44. 16-16 ). [QxMD MEDLINE Link]. This website also contains material copyrighted by 3rd parties. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Such patients usually demonstrate normal findings on pharyngograms or evidence of nonspecific lymphoid hyperplasia of the palatine or lingual tonsils. In contrast, lateral pharyngeal diverticula are persistent protrusions of pharyngeal mucosa, usually through the thyrohyoid membrane or, rarely, through the tonsillar fossa. Esophageal stasis was the most common finding regardless of complaint location. Esophageal dysmotility develops as the smooth muscle of the esophagus is replaced by scar tissue, gradually leading to progressive loss of peristalsis and a weakening of LES.
Assessment of Swallowing Disorders | Ento Key Rarely, pedunculated lesions (e.g., papillomas, lipomas, fibrovascular polyps) may be coughed up into the mouth or may cause sudden death through asphyxiation. Greatly increased prevalence of esophageal dysmotility observed in persons with spinal cord injury. Ive talked with team and parents both about aspiration risk and oral feeding aversion. Squamous cell carcinomas represent 90% of malignant lesions involving the oropharynx and hypopharynx. Rommel N, Omari TI, Selleslagh M, et al. Growth Disorders: 7 Cases of a Developing Problem, Trending Clinical Topic: Intermittent Fasting. 30(3):1-5. The underlying cause of all the primary motility disorders remains elusive. Some tumors may be detected during barium studies performed for other reasons. Better demonstration of webs is also achieved with the use of large boluses of barium. Transient or persistent protrusions of the anterolateral cervical esophagus into the Killian-Jamieson space are termed lateral cervical esophageal pouches or diverticula, respectively. J Neurogastroenterol Motil. This work supports a comprehensive evaluation of both the pharynx and the esophagus for patients with complaints of bolus stasis in the throat. The incidence of achalasia is 1-3 case per 100,000 population per year. The primary role is to clear the esophagus of retained food or any gastroesophageal refluxate. Muscles of the oral cavity, pharynx, and cervical esophagus are of the striated variety. endstream
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[Temporal and spatial pattern analysis of pharyngeal swallowing in patients with abnormal sensation in the throat]. Some webs are present in the valleculae or lower piriform sinus. In contrast, saccular cysts of the aryepiglottic folds arise from the mucus-secreting glands of the appendix of the laryngeal ventricle and are filled with mucoid secretions. Esophageal motility disorders may occur as manifestations of systemic diseases, referred to as secondary motility disorders. Thorac Surg Clin. 2021 Apr;30(4):105349. doi: 10.1016/j.jstrokecerebrovasdis.2020.105349.
what is pharyngeal stasis - floridacommerciallending.com Nihon Jibiinkoka Gakkai Kaiho. A new era in esophageal diagnostics: the image-based paradigm of high-resolution manometry. Image courtesy of Andrew Taylor, MD, Professor, Abdominal Imaging, Department of Radiology, University of Wisconsin Medical School, Madison. Praveen K Roy, MD, MSc is a member of the following medical societies: Alaska State Medical Association, American Gastroenterological AssociationDisclosure: Nothing to disclose. Lymphoid hyperplasia of the base of the tongue.
Pharyngeal Versus Esophageal Stasis: Accuracy of Symptom Localization Although the tests of association and correlation of the stasis variable did not present significance, it is . (From Rubesin SE: Pharynx. If it is not neurologic, could it be anatomic? hTmo6+bpNQ@av@A9G^I;Rr$;Y\#0"&Z2-t2& #WBq#@ @+$>EWuO72Ou-Zs*[P Jd|!6kSKWEsw]J]WfDvNj _i8n[&7gsct An ulcerated lesion appears as an irregular barium collection disrupting the expected contour of the base of the tongue. Conclusion Patients are poor at localizing bolus stasis, and esophageal stasis is common in patients who complain of pharyngeal stasis. Even after therapy, patients continue to have mild symptoms related to aperistaltic esophagus and, thus, will want to still follow careful eating habits. Many nasopharyngeal squamous cell cancers are undifferentiated tumors, and many have a reactive lymphoid stroma. Webs may be confused radiographically with redundant mucosa in the anterior wall of the pharyngoesophageal segment at the level of the cricoid cartilage. sharing sensitive information, make sure youre on a federal Inflammatory disorders of the pharynx or gastroesophageal reflux can alter pharyngeal elevation, epiglottic tilt, or closure of the vocal cords and laryngeal vestibule. Small or predominantly submucosal lesions may be hidden in the valleculae or the recess between the tongue and tonsil (glossotonsillar recess). Abdel Jalil AA, Castell DO. A zone of lymphoid tissue surrounds the epithelium. An official website of the United States government. Timing of events during deglutition after chemoradiation therapy for oropharyngeal carcinoma. The body of the esophagus is similarly composed of 2 muscle types. This region is bounded superiorly by the greater cornu of the hyoid bone, anteriorly by the thyrohyoid muscle, posteriorly by the superior cornu of the thyroid cartilage and stylopharyngeal muscle, and inferiorly by the ala of the thyroid cartilage. 16-11 ).
Pharyngeal swallowing phase and chronic cough Eur J Pediatr. Inflammation-induced dysmotility may result in laryngeal penetration and stasis. High-resolution manometry combined with impedance measurements discriminates the cause of dysphagia in children. X./X"spGO>'R3? Philadelphia, WB Saunders, 1992. The LES pressure tracing is at the level of the sleeve (tracing 6). What we know so far suggests a poor prognosis for being a full PO feeder at time of d/c from the NICU and the etiology(ies) is/are unlikely to resolve in the short term, given multiple complex co-morbidities, as yet not fully determined. Muller M, Eckardt AJ, Gopel B, Eckardt VF. Although esophagram shows a typical picture of achalasia, this patient had adenocarcinoma of the gastroesophageal junction. 110(7):967-77; quiz 978. This controversial finding causes difficulty in attributing symptoms or manometric abnormalities to muscle structure changes. Any ideas are greatly appreciated! Carcinoma arises in less than 1% of patients with Zenkers diverticulum, but it is usually fatal. Ronnie Fass, MD, FACP, FACG is a member of the following medical societies: American College of Gastroenterology, American College of Physicians-American Society of Internal Medicine, American Gastroenterological Association, American Neurogastroenterology and Motility Society, American Society for Gastrointestinal Endoscopy, Israeli Medical AssociationDisclosure: Received grant/research funds from Takeda Pharmaceuticals for conducting research; Received consulting fee from Takeda Pharmaceuticals for consulting; Received honoraria from Takeda Pharmaceuticals for speaking and teaching; Received consulting fee from Vecta for consulting; Received consulting fee from XenoPort for consulting; Received honoraria from Eisai for speaking and teaching; Received grant/research funds from Wyeth Pharmaceuticals for conducting research; Received grant/research funds f. Simmy Bank, MD Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine. Radiologists should be as familiar with pharyngeal carcinoma as they are with esophageal carcinoma. In some patients, this regurgitation of barium results in overflow aspiration. Gravesen FH, Gregersen H, Arendt-Nielsen L, Drewes AM. This association was termed Plummer-Vinson syndrome or Paterson-Kelly syndrome. In patients with known pharyngeal cancer, a contrast examination is of value to assist in planning proper work-up and therapy. The exception is the . Lateral view of the pharynx shows well-circumscribed plaques (. Retention cysts of the aryepiglottic folds are lined by squamous epithelium and filled with desquamated squamous debris ( Fig. 2017 Jun 30. A true Zenkers diverticulum may be confused with barium trapped above a cricopharyngeal muscle that has closed before the pharyngeal contraction wave has passed. Extrinsic nerves may also be affected, characterized by Wallerian degeneration of the axoplasm and myelin sheaths within the vagus nerve and dorsal motor nucleus. Pharyngeal phase problems include -having a hard time starting a swallow -getting food or liquid into your airway, called aspiration -having some food or liquid stay in your throat after you've swallowed, called residue. for stability and/or r/t tethered oral tissues, r/t mild mandibular hypoplasia). They should be well informed about its lifelong nature. In immunosuppressed patients with acute dysphagia, barium studies are directed toward the esophagus to demonstrate the presence, site, and type of esophagitis. Associated complications, including strictures, Barrett esophagus, and adenocarcinoma of the esophagus, are the concern. HU6?Q However, double-contrast examination of the pharynx may demonstrate the plaques of Candida pharyngitis or the ulcers of herpes pharyngitis, particularly in patients with AIDS ( Fig. Possible complications, therapeutic options, expected outcomes, and dietary modifications should be explained. Search google scholar for this article by my colleague and friend, Laura Brooks, which may or may not be pertinent, pending your further assessment and refection. Esophageal dysmotility may be caused by: An ulcer, stricture, irritation, infection, inflammation, or cancer in the esophagus. Purpose The purpose of this article was to determine whether patients who complain of bolus stasis are accurate at localizing bolus stasis as measured by a videofluoroscopic swallowing study with an esophagram.