Dysphagia
51 year old woman is evaluated for difficulty in swallowing solid foods. She experience chest pain while attempting to eat and often regurgitates swallowed food. Fluoroscopic examination of a barium swallow reveals a dilated lower esophagus with considerable residual barium remaining after the swallow .A manometric motility study of esophageal motility following a swallow reveals an absence of primary peristalsis in the distal third, without relaxation of contractile tone in the lower esophageal sphincter.
What is the explanation for the women’s dysphagia and what is the most likely explanation for the failure of the lower esophageal sphincter relaxation during the swallow?
No related posts.
Filed Under: Discussion
Hello Dr KNP.
The dysphagia, regurgitation, chest pain and failure of lower esophageal sphincter to relax are suggestive of Achalasia(‘failure to relax’).
The failure of the lower esophageal sphincter could be explained by the fact that in achalasia both muscles and nerves are affected. We have inflammation of the muscle of the lower esophagus. This is followed by a degeneration of the nerves, particularly those causing the lower esophageal sphincter to relax.