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Oropharyngeal dysphagia is not a single disease but a symptom complex that is recognized by difficulty in transfer of a food bolus from mouth to esophagus or by signs and symptoms of aspiration pneumonia or nasal regurgitation. Its etiologies are legion, with the most common result of underlying neuromuscular disease, including cerebrovascular accidents, Parkinson's disease, multiple sclerosis, and muscular dystrophy. There are two methods of treatment for oropharyngeal dysphagia; one is specific and directed at the underlying disease and the other is general (supportive) and designed to preserve oral intake for nutrition while preventing aspiration pneumonia. Following a general discussion of the etiology and clinical presentation of orophyarngeal dysphagia, a description of the methods for supportive care is presented as well as the approach to the treatment of cricopharyngeal dysfunction and Zenker's diverticulum.

Pill esophagitis is a preventable cause of morbidity. Simple advice on how and when to take medication could probably prevent most cases of the illness. Avoidance of implicated medications in patients with significant risk factors for developing pill esophagitis could prevent additional cases. When the disease presents despite these preventive measures, the mainstays of treatment are immediate discontinuation of the offending agent and supportive care. If the diagnosis is in question, the principle diagnostic modalities are double-contrast barium esophagogram and esophagogastroduodenoscopy. Medical management of moderate to severe cases includes sucralfate to coat, protect, and promote healing of ulcerated esophageal mucosa, and acid-suppressing therapy if gastroesophageal reflux disease is felt to have played a role in the pathogenesis of the illness. Rare cases may require therapeutic endoscopy or surgical intervention early in the disease course. Late complications include esophageal strictures that may require therapeutic endoscopy or bougienage.