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Dysphagia is a term for swallowing difficulties. Some patients struggle with swallowing certain foods or liquids, while other patients may not be able to swallow at all. Other signs of dysphagia include coughing or choking when eating or drinking, bringing food back up, (sometimes through the sinus cavity / nose). A number of conditions can be associated with dysphagia including ALS but also in some patients with limited cutaneous systemic sclerosis where the esophagus and other parts of the gut are affected by the disease. Antibody studies can help track down the underlying cause of dysphagia, such as he presence of anti-centromere antibodies in scleroderma or Raynaud’s phenomenon.