Concluded Case

40 yrs male presented with refractory dry cough, hoarseness of voice since childhood, difficulty in swallowing since last one year. he underwent OGD Scopy, which revealed achalasia cardia. yesterday video laryngoscopy is also done which shows narrow vocal cords opening. he is hemodynamically stable. routine lab reports are normal. plz go through images and guide further investigations and management plan.

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Concluded answer

High resolution manometry is more informative than gi scopy for achalasia cardia . Regurgitation can lead to above mentione symptoms. Meanwhile start PPI and followup on that

All Answers

In case of achalasia cardia recurrent regurgitation can cause laryngeal edema follwed by chronic inflammation... Even if PPI are started the non acid reflux will be continued... So best would be doing Manometry first followed by definative surgery.. At present can give trial of balloon dilatation along with Acud relflux therapy...

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Regurgitation of food from dilated lower oesophagus is responsible for dry cough, hoarseness of voice since childhoid in this case GERD and Achalasia may be two ends of a spectrum, but they can co exist. In fact, some believe that Chronic GERD, can cause Achalasia. Addition of PPI may help Achalasia Nice demonstration of Cause and Effect

Valuable opinion
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Rather than doing OGD scopy to find out Acalasia cardia ,high resolution manometry is informative in pinpointing AC.A detailed history taking for not taking any trt since childhood is to be elicited in this case.Oesophageal diverticulam must be ruled out. A short course of PPI can be tried to infer whether it is a case of reflex oesophagitis.

Thanks sir, short course PPI initiated.
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High resolution manometry is more informative than gi scopy for achalasia cardia . Regurgitation can lead to above mentione symptoms. Meanwhile start PPI and followup on that

Valuable opinion
0

Rotation +. Chest scan NAD.

Rotation + Chest scan NAD.

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