A 45-year-old woman presents to the gastroenterology clinic with symptoms of difficulty swallowing, regurgitation of undigested food, and chest pain. The gastroenterologist suspects a motility disorder of the esophagus and plans to confirm the diagnosis with an appropriate investigation.
Manometry is the investigation of choice for:
A. CLD (Chronic Liver Disease)
B. Achalasia esophagus
C. Barrett esophagus
D. Carcinoma esophagus
E. Benign disease of esophagus
Answer:
The Correct Answer is: B. Achalasia esophagus
Explanation:
Achalasia esophagus (B):
– Manometry is the investigation of choice for diagnosing achalasia esophagus. It measures the pressure within the esophagus and the function of the lower esophageal sphincter (LES).
– In achalasia, manometry typically shows a lack of normal peristalsis in the esophageal body and failure of the LES to relax properly during swallowing. This diagnostic tool is crucial for confirming the diagnosis and differentiating achalasia from other motility disorders.
Explanation of Incorrect Options:
CLD (Chronic Liver Disease) (A):
– Manometry is not used for diagnosing chronic liver disease. CLD is typically diagnosed with liver function tests, imaging studies, and sometimes liver biopsy.
Barrett esophagus (C):
– Barrett esophagus is diagnosed with upper endoscopy and biopsy, not manometry. Manometry does not assess the cellular changes characteristic of Barrett esophagus.
Carcinoma esophagus (D):
– Carcinoma of the esophagus is diagnosed with endoscopy and biopsy. Imaging studies like CT or PET scans are used to assess the extent of the disease. Manometry is not used for diagnosing esophageal cancer.
Benign disease of esophagus (E):
– While manometry can be used for some benign esophageal conditions, it is specifically indicated for diagnosing motility disorders such as achalasia. Other benign conditions might require different diagnostic approaches such as endoscopy or barium swallow.
In conclusion, manometry is the investigation of choice for achalasia esophagus, making option B the correct answer.