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Medicine Bleeding from the GUT and diseases of esophagus b2723578

Non progressive dysphagia in a lady with a sensation of something stuck in the throat and worsened by intake of cold drinks is suggestive of?

A
Diffuse esophageal spasm
B
Upper esophageal web
C
Achalasia
D
Scleroderma
High-Yield Explanation
Non progressive dysphagia is seen in choice a and b while choice c and d have progressive dysphagia. Diffuse esophageal spasm presents with non-cardiac chest pain and globus (something stuck in the throat). Pain may be associated with eating quickly or drinking hot, cold, or carbonated beverages. Patients with nutcracker esophagus or high-amplitude peristaltic contractions usually present with chest pain, as only 10% experience dysphagia. The hallmark symptom of esophageal rings and webs is dysphagia mainly to solid food usually is greater than dysphagia to liquid food. Since in this question cold drink is worsening and not improving the symptom of dysphagia, oesophageal web is a unlikely answer. When lumen diameter is less than 13 mm due to mucosal ring(Schatzki ring) episodic solid food dysphagia is seen.

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