Findings

Cricopharyngeal dysfunction

Also written as CP dysfunction, Cricopharyngeal bar, CP bar, Reduced UES opening, Incomplete UES opening, CPD.

Cricopharyngeal dysfunction means the muscle at the very bottom of the throat did not relax or open normally to let the swallow pass through.

At the very bottom of the throat sits a ring of muscle called the cricopharyngeus. It stays shut most of the time and lets go for a moment during each swallow so food and liquid can pass into the esophagus, the tube leading to the stomach. That ring is the main working part of the upper esophageal sphincter, often shortened to UES. Cricopharyngeal dysfunction is the phrase used when that brief opening does not happen the way it normally would.

Reports describe this in a few different ways. One paper defines failure of the cricopharyngeus muscle to relax at the right time during swallowing, when no other motor problem is present, as primary cricopharyngeal dysphagia. Another describes the problem as poor coordination, or a smaller-than-usual maximum opening as the swallow passes through. On a moving X-ray of swallowing, the muscle can show up as a shelf pressing in from behind the column of barium at the pharyngoesophageal junction, the point where throat meets esophagus. That shelf is written up as a cricopharyngeal bar. A report may note narrowing at this level with barium left sitting above it.

This is a description of one spot in the swallow, not a diagnosis on its own. A cricopharyngeal bar can also turn up in people who have no swallowing complaints at all, which is why clinicians read it alongside everything else in the same study rather than by itself. It is described in the literature as difficult to identify and best seen on a videofluoroscopic swallow study. The finding says what the muscle did during the study. It does not say why, and it does not say what happens next.

An SLP notes this because the very end of the swallow is a doorway, and if that doorway does not open fully, material can stay behind in the throat instead of moving on. Knowing whether the holdup is at that last step, rather than earlier in the mouth or throat, helps the team decide which part of the swallow to look at more closely and who else may need to be involved. Because the same finding shows up in people with symptoms and in people without any, its presence on a report tells you nothing on its own about your own swallow or what should change.