A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He doesn’t smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? A- Cancer esophagus B- Peptic esophageal stricture C- Diffuse esophageal spasm D- Achalasia E- Lower esophageal ring Answer: http://medical-usmle.com/?p=680
