Question

A 68-year-old man who has smoked for at least 50 years reports that lately he feels as though food is "getting stuck" in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least five alcoholic beverages nearly every day. His problem is most likely:A) achalasia.B) squamous cell carcinoma of the esophagus.C) dysphagia secondary to scleroderma.D) gastrointestinal reflux disease.

Answer 1

Squamous cell carcinoma of the esophagus is a lethal disease of elderly (of 67 years and above), usually associated with dysphagia .It risk factors are alcohol,(a causative agent in this scenario) tobacco use, achalasia.

This condition affects the esophageal motility due to loss of esophageal smooth muscles cells and lower esophageal splinter (that separated the upper part of the stomach from the esophagus.) The gradual loss of the smooth muscles cells to cancer is responsible for the dysphagia.

Difficulty in swallowing and regurgitation is called Achalasia, which is due to failure of the smooth muscles cells to relax, therefore the esophageal sphincter remained closed; foods chyme cannot leave stomach but regurgitated to the mouth. Inflammation of the esophagus is gastrointestinal reflux

It is common in black elderly communities

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