The esophagus is a small hose-like tube which connects the mouth to the stomach. As it leaves the mouth, it follows a straight path through the neck and chest, passing near the heart through the diaphragm muscle and finally entering the stomach. The esophagus walls are composed of muscles which move in wave-like contractions to push food into the stomach.

The cricopharyngeal muscle is located near the mouth, at the beginning of the esophagus. This small muscular band attaches to the esophageal muscles and functions to regulate the passage of food from the mouth cavity into the esophagus. Cricopharyngeal achalasia is a failure of the cricopharyngeal muscle to relax. The unrelaxed muscle closes off the opening of the esophagus, thus preventing food from leaving the mouth because it cannot be swallowed. Although the exact cause for the abnormal muscular constriction is unknown, it is believed to be a disorder of the nerves supplying the cricopharyngeal muscle. Most cases of this disorder are caused by congenital abnormalities and therefore appear early in life.

What are the symptoms?

It is difficult or impossible for a patient with cricopharyngeal achalasia to swallow food. Food may fall from the mouth. Upon drinking water, the patient may cough as liquid enters the trachea, then the lungs.

What are the risks?

Left untreated, the patient will lose weight and possibly starve to death due to the inability to eat.

What is the management?

Surgery is required to sever the cricopharyngeal muscle, thus releasing the tension or constriction of the beginning of the esophagus. The outcome after surgery is generally good and patients live a normal life span.

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