If an animal is able to prehend food, takes multiple attempts to swallow without success, and formed a food bolus that was regurgitated, where is the dysphagia localized?

• A. Cricopharyngeal dysphagia
• B. Oropharyngeal dysphagia
• C. Esophageal dysphagia
• D. Gastric dysphagia

Answer: (A)

Problem is localized to the pharyngoesophageal junction, where the cricopharyngeus muscle must relax to allow the swallowed bolus to pass into the esophagus. When an animal can grasp food, makes several swallowing attempts without success, and then regurgitates a formed bolus, it points to a failure of the upper esophageal sphincter to relax. The bolus never enters the esophagus and is expelled back through the mouth, which is classic cricopharyngeal dysphagia.

If the issue were in the esophagus proper, you'd expect the bolus to progress into the esophagus but get stuck there, with symptoms centered more distally and not immediate regurgitation of a formed bolus back out. Oropharyngeal dysphagia would typically present with trouble initiating a swallow, coughing, or nasal regurgitation during the swallow, rather than regurgitation of a bolus formed in the pharynx. Gastric dysphagia describes problems after the swallow that involve the stomach, not the initial pharyngeal phase.