Dysfunction of the Cricopharyngeus Muscle: Exploring Symptoms, Triggers, Treatments, and Additional Information
Cricopharyngeal dysfunction is a condition that affects the muscle at the top of the throat, known as the cricopharyngeal muscle (CPM). This condition can cause difficulty swallowing, painful swallowing, choking, voice changes, coughing when eating or drinking, fear of eating, and pneumonia. In some cases, the dysfunction may be idiopathic, meaning there is no identifiable underlying cause.
Idiopathic cricopharyngeal dysfunction occurs when the CPM fails to relax properly. Despite extensive research, the precise causes of idiopathic cases remain poorly defined. However, some related insights can be synthesized.
Retrograde cricopharyngeal dysfunction (R-CPD) occurs when the CPM stays too tight, blocking gas escape, causing symptoms like bloating and abdominal discomfort. This condition may be considered functional or idiopathic when no clear anatomical or neurological cause is identified.
Other structural causes of dysphagia involving similar regions include conditions like Diffuse Idiopathic Skeletal Hyperostosis (DISH), which can cause mechanical obstruction due to cervical spine bone growth. However, these represent non-idiopathic, identifiable causes.
Neuromuscular diseases, such as inflammatory myopathies like inclusion body myositis, can cause cricopharyngeal dysfunction due to muscle involvement. However, these are not idiopathic causes—they have identifiable pathological processes.
Cricopharyngeal spasm may occur, sometimes idiopathically, but also in association with neurological or muscular conditions.
In summary, true idiopathic cricopharyngeal dysfunction often implies a functional disorder where the muscle fails to relax without an apparent cause such as neurological disease, structural abnormalities, inflammatory or myopathic muscle diseases, post-surgical or traumatic changes.
Diagnosis of cricopharyngeal dysfunction typically involves an X-ray swallow test or esophageal manometry, which measures the muscle contractions that occur when a person swallows. A person can see an otolaryngologist to receive a diagnosis.
Treatment options for cricopharyngeal dysfunction include surgery, exercises, and Botox injections. Stapling can be a less invasive surgical option to treat cricopharyngeal dysfunction in some cases. Endoscopic cricopharyngeal myotomy uses carbon dioxide (CO) lasers to improve cricopharyngeal dysfunction. Dilatation, which involves stretching the esophagus to increase its size and loosen the CPM, can significantly improve symptoms, but it is not a permanent solution and will need to be repeated over time.
Exercises such as the Shaker exercise and Mendelsohn maneuver may help alleviate symptoms of cricopharyngeal dysfunction. Doctors may also recommend certain food types to help manage symptoms.
A 2015 review found that only 6% of people who had CO laser surgery had recurring symptoms, compared with 26% of people who had stapler surgery.
In children, symptoms can include difficulty swallowing, choking, coughing, recurring pneumonia, and nasal congestion. Posture can impact cricopharyngeal function, and stress can worsen symptoms in people with cricopharyngeal dysfunction.
In conclusion, while the exact causes of idiopathic cricopharyngeal dysfunction are not fully understood, treatment options are available to help manage and improve symptoms. It is essential to consult with a healthcare professional for a proper diagnosis and treatment plan.
- Idiopathic cricopharyngeal dysfunction, which affects the muscle at the top of the throat, might cause anxiety about eating due to difficulty, pain, choking, voice changes, and coughing.
- Retrograde cricopharyngeal dysfunction can induce symptoms like bloating and abdominal discomfort because the muscle fails to relax, potentially leading to functional or idiopathic conditions.
- Other medical-conditions, like neuromuscular diseases or Diffuse Idiopathic Skeletal Hyperostosis, can cause cricopharyngeal dysfunction, but these are not idiopathic as they have identifiable pathological processes.
- Treatment for cricopharyngeal dysfunction involves surgical procedures like endoscopic cricopharyngeal myotomy, which uses CO lasers, and less invasive options like stapling or dilatation.
- Fitness-and-exercise strategies, such as the Shaker exercise and Mendelsohn maneuver, can potentially alleviate symptoms associated with cricopharyngeal dysfunction.
- CBD has not been scientifically proven to directly treat cricopharyngeal dysfunction or neurological disorders, but it may help manage symptoms related to stress and anxiety, contributing to overall health-and-wellness.
