All of the following are features of Paterson-Brown-Kelly syndrome, except:
**Core Concept**
Paterson-Brown-Kelly syndrome, also known as Achalasia, is a primary esophageal motility disorder characterized by the failure of the lower esophageal sphincter (LES) to relax, leading to difficulty in swallowing and regurgitation of food.
**Why the Correct Answer is Right**
Achalasia is caused by degeneration of the myenteric plexus, which disrupts the normal coordination of peristalsis and leads to a failure of the LES to relax. This results in a functional obstruction of the esophagus, causing symptoms such as dysphagia, regurgitation, and weight loss. The LES remains contracted, and the esophageal body exhibits non-peristaltic, simultaneous contractions.
**Why Each Wrong Option is Incorrect**
**Option A:** Dysphagia to liquids is a characteristic feature of achalasia, so this option is incorrect.
**Option B:** Regurgitation of food is a common symptom of achalasia, so this option is incorrect.
**Option C:** Weight loss is a consequence of chronic dysphagia and malnutrition, making it a correct feature of achalasia.
**Clinical Pearl / High-Yield Fact**
Achalasia is often associated with an absence of peristalsis in the esophageal body and a failure of the LES to relax. This can be confirmed on a barium swallow study, which shows a "bird's beak" appearance of the esophagus.
**Correct Answer:** A. Dysphagia to solids is a characteristic feature of achalasia, while dysphagia to liquids is more typical of other esophageal disorders, such as esophageal stricture or diffuse esophageal spasm.