Step 2

Gastroenterology 6

A 57-year-old man presents to the physician for halitosis, regurgitation of undigested food, progressive difficulty swallowing, and an occasional gurgling noise in the throat for the past 4 months. He has not experienced odynophagia, nausea, vomiting, heartburn, or weight loss. He has a history of gastroesophageal reflux disease which is well-controlled with proton pump inhibitor, and he was evaluated with an endoscopy which was unremarkable two years ago. He does not smoke cigarettes or drink alcohol. Physical examination is unremarkable.

Which of the following is the next best step in the evaluation of this patient?

  • A) Ambulatory esophageal pH monitoring
  • B) Barium esophagography
  • C) Esophageal manometry
  • D) No diagnostic testing necessary
  • E) Repeat upper endoscopy


Marina Tawadrous


Dr. Raj Dasgupta