A 29-Year-Old Man Comes to the Office Due to Difficulty

A 29-year-old man comes to the office due to difficulty swallowing for the past 2 years.  Pork, chicken, and steak occasionally "get stuck" in his mid-chest seconds after he swallows.  These episodes occur intermittently but with increasing frequency.  Drinking water usually alleviates the symptoms, but the patient occasionally induces vomiting to eject the food.  He has no trouble swallowing water, broth, or gelatin.  The patient has no pain, cough, or nasal regurgitation after swallowing.  He frequently plays football and takes ibuprofen to relieve aches and pains.  He has seasonal allergies and takes antihistamines during the spring.  Temperature is 37.3 C (99.1 F) , blood pressure is 125/78 mm Hg, pulse is 76/min, and respirations are 12/min.  BMI is 28 kg/m².  Heart and lung sounds are unremarkable.  The abdomen is soft, nontender, and nondistended.  Which of the following is the most likely explanation for this patient's symptoms?

A) Achalasia
B) Eosinophilic esophagitis
C) Esophageal cancer
D) Herpes esophagitis
E) Myasthenia gravis
F) Pill esophagitis

Correct Answer:

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