achilles
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once achalasia cardia has been more or less diagnosed after doing the barium studies what is the next step ?
UW says EGD to rule out other mechanical causes of dysphagia and kaplan says manometry.
which one should we do first ?
eventually we end up doing both...what bugs me is why bother with which one to do next when we always need to do both ! pls do correct me if i am missing anything on this point.
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| aimhigh
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 , the reason that we have to bother thinking which is first is that we are the testtaker instead of examiner.
O.K. For this case, we need to rule out other causes of "achalasia-like" because doing manometry to confirm the diagnosis. EGD is the right tool to exclude the maliganency, stricture etc. So especially for an adult, the sequence of testing a patient that cannot swallow both solid and liquid food is
1) contrast study (Barium)
2) Endoscopy to rule out other causes
3) Manometry to confirm the dx
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| aimhigh
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sorry for the mistyping: "because" should be replaced with "before" and "cannot swallow" should be with "has difficulty swallowing"
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| achilles
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thanks aimhigh.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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