Embrace the testing process
If chronic swallowing difficulties have you suspecting you may have R-CPD (Retrograde Cricopharyngeus Dysfunction), there are a few key diagnostic tests that can help confirm the condition.
A proper diagnosis from professionals like gastroenterologists, otolaryngologists, or speech-language pathologists is important before proceeding with treatment options. Here are some of the main diagnostic exams used:
Modified Barium Swallow Study (MBSS)
Also known as a video fluoroscopy, this is the most common diagnostic test for R-CPD. It involves swallowing barium contrast material while video X-rays capture real-time images of the swallowing process. The barium allows the detailed motions of swallowing to be visualized. An MBSS can identify where in the swallowing anatomy the dysfunction is occurring. Finding a narrowing at the upper esophageal sphincter points to R-CPD.
Esophagoscopy
This test uses a thin, flexible endoscope inserted through the mouth down to the esophagus. A tiny camera on the endoscope allows visual examination of the esophagus and upper sphincter. Esophagoscopy can evaluate if there are strictures or other abnormalities contributing to the swallowing difficulty. It is often done in combination with manometry.
Manometry
Esophageal manometry analyzes the muscle contractions along the esophagus during swallowing. A pressure-sensitive tube is inserted into the esophagus and as you swallow, it detects irregularities in the wave-like squeezing motions that move food through the esophagus. Abnormal patterns at the upper esophageal sphincter indicate possible R-CPD.
Imaging Tests
CT scans or MRI imaging may be ordered to get detailed anatomical views of the throat and esophagus. This allows ruling out the possibility of cancer, strictures, or other structural issues leading to dysphagia. Imaging is not a primary diagnostic tool for R-CPD but complements other testing.
The combination of a thorough clinical evaluation and these diagnostic exams can confirm a diagnosis of R-CPD. The testing provides vital information for understanding the degree of dysfunction and guiding treatment approaches, whether therapy, medications, dilations, or othe