Question

A 35-year-old man presents with a 4-week history of difficulty swallowing food. He has developed chest pain over the last few days, and he has also noticed regurgitation of food. On detailed history, he says that the regurgitation contains undigested fragmented food material; it is unassociated with a foul smell. He has lost 3 kg over the past month.

On examination, his pulse is 94 bpm and blood pressure is 130/86 mm Hg. Mild pallor is noted, but there is no icterus. Epigastric tenderness is present. CBC shows a hemoglobin of 9.5 g/dL (total count 7400 cells/mm3 and ESR 12 mm/hr). An X-ray of the abdomen shows an absence of a fundic air shadow. The patient undergoes barium studies which show a dilated esophagus; the lower end appears beak-shaped.

What is the most common cause for the above condition?

1 Diabetes mellitus
2 Chagas disease
3 Eosinophilic gastroenteritis
4 Neurodegenerative disorder
5 Primary idiopathic

Answer 1

Yes that is true because you know why because it is

Answer 2

A 35-year-old man presenting with difficulty swallowing, chest pain, and regurgitation likely has Achalasia, a condition most commonly caused by a primary idiopathic process involving esophageal nerve degeneration.

Step-by-step explanation:

The condition described by the symptoms of difficulty swallowing (dysphagia), chest pain, regurgitation of undigested food, absence of a fundic air shadow on X-ray, and a beak-shaped lower end of the esophagus is suggestive of Achalasia. The barium studies typically show a dilated esophagus with a beak-shaped lower end due to the failure of the lower esophageal sphincter to relax. The most common cause for Achalasia is a primary idiopathic process, where the etiology is not fully understood, but is thought to involve the degeneration of nerves in the esophagus.