Intermittent dysphagia is caused by -a) Strictureb) Reflux esophagitisc) Achalasia cardiad) Pharyngeal diverticululame) Diffuse esophageal spasm

**Core Concept**
Intermittent dysphagia refers to episodic difficulty swallowing that may be influenced by factors such as eating posture, food consistency, or emotional state. This symptom can be caused by various esophageal conditions that affect the motility or structure of the esophagus.

**Why the Correct Answer is Right**
Achalasia cardia (Option C) is a motility disorder characterized by the failure of the lower esophageal sphincter (LES) to relax, leading to intermittent dysphagia, especially to solid foods. Diffuse esophageal spasm (Option E) is a condition where abnormal contractions of the esophagus occur, resulting in severe, intermittent chest pain and dysphagia.

**Why Each Wrong Option is Incorrect**
**Option A:** Stricture (Option A) is a fixed narrowing of the esophagus, usually caused by chronic inflammation or scarring, which leads to persistent dysphagia rather than intermittent.

**Option B:** Reflux esophagitis (Option B) can cause chronic dysphagia due to the formation of strictures or esophageal rings, but it is not typically associated with intermittent dysphagia.

**Option D:** Pharyngeal diverticulum (Option D) may cause intermittent dysphagia, but it is less likely compared to achalasia and diffuse esophageal spasm.

**Clinical Pearl / High-Yield Fact**
Keep in mind that intermittent dysphagia often suggests a motility disorder, whereas chronic dysphagia is more commonly associated with structural abnormalities.

**Correct Answer:**
✓ Correct Answer: C. de. Achalasia cardia and diffuse esophageal spasm are both characterized by intermittent dysphagia.