Older woman with dysphagia to solids and liquids with intermittent regurgitation of undigested food and halitosis, most consistent with achalasia which can be worked up with barium swallow (or esophageal manometry)
Key idea: Dysphagia to solids AND LIQUIDS is due to problems with esophageal motility, whereas dysphagia with solids that later leads to dysphagia to liquids more associated with obstructing mass lesions (cancer, esophageal stricture, etc.) that should be worked up with endoscopy
drmohandesProbably Zenker's diverticulum instead of achalasia, but barium swallow still valid.+11
usmile1ehh, theres nothing given in the question that would suggest a diagnosis of Zenker's diverticulum over achalasia. Halitosis, dysphagia for solids and liquids, and regurgitation of undigested foods can be seen with achalasia. Thus, a barium is needed+
link981@usmile1 actually there is something in the question that suggests Zenker's diverticulum over achalasia. "OCCASIONALLY REGURGITATES UNDIGESTED FOOD", but yeah you need to confirm the diagnosis and the next best step would be a Barium Swallow.+
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