A 60-year old male presents with progressive difficulty in swallowing, vomiting and occasional regurgitation for the past 3 months. Barium studied showed marked dilatation of the upper esophagus with narrowing of the lower segment. Manometry showed absent esophageal peristalsis. This patient needs to have -

The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of stomach acid occurring in patients with heaburn. Patients with a narrowed poion of the esophagus often have trouble swallowing; food feels like it is "stuck" in the chest region, causing discomfo or pain. Less common causes of esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves . Esophageal Dilation. During esophageal dilation (also called pneumatic dilation), an endoscopic tube is inseed through the mouth and into the esophagus. A balloon is expanded inside the esophagus to stretch muscle fibers inside the lower esophageal sphincter (LES). Ref Davidson edition23rd pg 729