Dysphagia Difficulty swallowing. Causes Intraluminal: Infection: candidiasis, pharyngitis, retropharyngeal abscess. Oesophagitis Foreign body. Polyps Intramural: Benign strictures (GORD) or malignant strictures. Achalasia Oesophageal web (Plummer Vinson syndrome): iron deficiency anaemia leads to desquamated epithelium. Commonest in middle-aged women. Oesophageal ring (Schatzki ring): ring of mucosal tissue. Oesophageal spasm. Systemic sclerosis. Extramural: Pharyngeal pouch. Rolling hiatus hernia. Malignancy Retrosternal goitre. Thoracic artery aneurysm. Neurological: Stroke, myasthenia gravis, MS, MND, Parkinson's. See bulbar and pseudobulbar palsy.