Nocturnal Regurgitation Of Undigested in Medicine / Internal Medicine — 46yo Man | Gastroenterology | SMLE Q#18338
SMLE Question #18338
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-ACH-001
Last updated: February 2026
A 46-year-old man has 8 months of progressive dysphagia to solids and liquids with nocturnal regurgitation of undigested food. He has lost 6 kg and reports intermittent, noncardiac chest discomfort. Upper endoscopy shows no obstructing lesion. Barium swallow shows a dilated esophagus with smooth tapering at the gastroesophageal junction. High-resolution manometry demonstrates impaired lower esophageal sphincter relaxation with absent peristalsis. What is the most appropriate definitive treatment?
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