18th July 2023

You review a 78-year-old woman in a gastroenterology clinic. She has been undergoing investigations for a 7-month history of dysphagia

You review a 78-year-old woman in a gastroenterology clinic. She has been undergoing investigations for a 7-month history of dysphagia and weight loss. She describes the sensation of food ‘sticking’ and getting caught in the oesophagus. She undergoes some initial investigations: both a CT abdomen and pelvis and gastroscopy are normal. She subsequently undergoes a barium swallow assessment, which reveals a ‘bird’s beak’ appearance at the lower oesophagus. Oesophageal manometry demonstrates increased pressure at the lower oesophageal sphincter. At her last clinic appointment, you diagnosed her with achalasia. She returns to the clinic accompanied by her son who is very concerned. He has read various complications associated with achalasia online and has written down some conditions on a piece of paper.

Of the options listed, which of the following is the most common complication of untreated achalasia?

Select the SINGLE most appropriate option from the list below. Select ONE option only.