[Dysphagia] UES/Reflux query

[acellucc at bidmc.harvard.edu (acellucc@bidmc.harvard.edu)]

I've got a question that borders on the hypothetical, but was wondering if anyone knows of any evidence of a causal relationship between problems with the lower esophagus and/or reflux and the subsequent development of UES dysfunction. We had someone recently who seemed to have a significantly prominent UES (we've recommended manometry), but there's also this issue of dysmotility and ? of reflux (all currently in w/u based on the video). We'd mentioned our question to a GI doc/resident who didn't seem to think there could be a relationship between the two b/c of the fact that the top 1/3 is striated muscle vs lower 2/3 smooth muscle and that were was no shared relationship between nerve pathways of UES/LES, but I still seem to have a hard time seeing how these could be happening independently of each other, as though they exist in a vacuum or don't influence one another. It would almost seem that the UES issue could be in response to chronic backflow or reflux. Anybody have any ideas??
thanks in advance, 
alex cellucci