A 50-year-old gynecologist complains of dysphagia, regurgitation, and weight loss. She also states that she feels as if food is stuck at the level of the xiphoid. An upright chest x-ray shows a dilated esophagus with an air-fluid level. Which of the following is FALSE?
The symptoms and radiologic findings in this patient suggest achalasia. Evaluation includes endoscopy to rule out a stricture or cancer. Barium swallow will show a dilated esophagus, failure of the LES to relax during swallowing, and a lack of peristalsis. Nonoperative management is of limited usefulness but may be considered in high-risk patients who are not candidates for surgery.
A barium swallow will show a "bird's beak" deformity
Manometry will demonstrate that the LES fails to relax during swallowing.
Upper endoscopy should be avoided because of the risk of complications.
Medical treatment includes nitrates and calcium channel blockers.
Stomach & Duodenum