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BOF: 79

A 40-year-old male presents with a history of intermittent, but slowly progressive dysphagia for both solids and liquids. He experiences pain on swallowing and has regurgitation of food swallowed several hours earlier. He has no heartburn but has anorexia and weight loss.

Ba swallow demonstrates proximal dilatation of the oesophagus and failure of relaxation of the lower oesophageal sphincter.

In this patient good medium to long term relief of symptoms may be obtained by:

a)      Oesophageal myotomy

b)      Amyl nitrite

c)      Amlodipine

d)    Intrasphincteric botulinum toxin

e)      Oesophageal bouginage

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