A 45 year old woman complains of pain in her hands precipitated by exposure to the cold weather. She also has breathlessness on walking. When she eats, she can feel food sticking to her throat. She finds it difficult to swallow. It is usually relieved with a drink of water. What is the SINGLE most likely cause of her dysphagia?
A. Oesophageal carcinoma
B. Systemic sclerosis
C. Systemic Lupus Erythematosus
D. Pharyngeal carcinoma
E. Globus hystericus
Diagnosis is quite clear here. Systemic sclerosis may present with pain in hands when exposed to cold (Raynaud’s phenomena), shortness of breath (pulmonary fibrosis), and dysphagia (oesophageal dysmotility).
Systemic sclerosis Is one of the causes of dysphagia.
Other features of CREST syndrome may be present, namely Calcinosis, Raynaud’s phenomenon, Oesophageal dysmotility, Sclerodactyly, Telangiectasia
As well as oesophageal dysmotility the lower oesophageal sphincter (LES) pressure is decreased. This contrasts to achalasia where the LES pressure is increased