30 years of women comes with dysphagia for both solid & liquids. Barium swallow shows Parrot beak appearance. On esophageal manometry, increased LES pressure. Management includes:
**Core Concept**
The patient's symptoms and diagnostic findings suggest achalasia, a motility disorder of the esophagus characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent peristalsis in the esophageal body. This leads to difficulty swallowing both solids and liquids, and a characteristic "bird-beak" appearance on barium swallow.
**Why the Correct Answer is Right**
In achalasia, the LES fails to relax properly, leading to increased pressure and a functional obstruction. This is due to degeneration of the myenteric plexus, which is responsible for regulating esophageal motility. The increased LES pressure prevents normal passage of food into the stomach, resulting in dysphagia. Esophageal manometry is a key diagnostic tool, demonstrating the characteristic pattern of absent peristalsis and increased LES pressure.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided.
**Option B:** This option is not provided.
**Option C:** This option is not provided.
**Option D:** This option is not provided.
**Clinical Pearl / High-Yield Fact**
Achalasia is often associated with other motility disorders, such as gastroesophageal reflux disease (GERD) and diffuse esophageal spasm. It is essential to consider achalasia in the differential diagnosis of dysphagia, especially when symptoms are progressive and unresponsive to conservative management.
**Correct Answer:** .