Which signs are listed as part of the cricopharyngeal-pharyngeal phase?

• A. Hard repetitive swallowing, odynophagia, gagging, eructation, bloating, flatulence
• B. Regurgitation, lip licking, neck extension during swallowing, restlessness
• C. Lip licking, regurgitation, coughing, sneezing
• D. Drooling, coughing, nasal discharge, pawing at face

Answer: (A)

The cricopharyngeal-pharyngeal phase is the step where the bolus must pass through the pharyngoesophageal (cricopharyngeal) sphincter. When this region doesn’t relax or work smoothly, you see signs that reflect the effort to push the bolus through and the body's response to that struggle. Hard repetitive swallowing shows the person keeps trying to move the bolus forward, signaling a partial obstruction at the cricopharyngeal level. Odynophagia, or pain with swallowing, often accompanies irritation or spasm at this junction, so swallowing becomes uncomfortable. Gagging is a protective reflex that can occur when the bolus stalls at the sphincter and triggers the airway-defense mechanism. If swallowing is repeatedly attempted, air can be swallowed as well, leading to eructation (belching) and, from the ongoing aerophagia, bloating and flatulence. Put together, these signs map onto the difficulty of transferring material through the cricopharyngeal sphincter and the body’s compensatory responses to that challenge.