PAEA Surgery End Of Rotation (EOR) Practice Exam

What describes achalasia?

1. Reflux of gastric contents

2. Failure of the LES to relax during swallowing

3. Increased motility of the esophagus

4. Esophageal inflammation

The correct answer is: Failure of the LES to relax during swallowing

Achalasia is characterized specifically by the failure of the lower esophageal sphincter (LES) to relax appropriately during swallowing. This condition results in a disruption of the normal passage of food from the esophagus into the stomach. Due to the inability of the LES to open, patients often experience difficulty swallowing (dysphagia), regurgitation of undigested food, and chest pain. The condition is also often associated with increased pressure in the esophagus above the LES. In contrast, the other options describe different gastrointestinal issues. Reflux of gastric contents refers to gastroesophageal reflux disease (GERD), which involves the abnormal flow of stomach contents back into the esophagus, not related to LES relaxation. Increased motility of the esophagus would imply a hyperactive or usable esophageal peristalsis, rather than the diminished motility seen in achalasia, where esophageal contractions are usually weak and ineffective. Lastly, esophageal inflammation could be indicative of conditions like esophagitis, which is not a defining feature of achalasia but could occur as a consequence of chronic retention of food in the esophagus during achalasia. Therefore, the option that accurately describes achalasia is the failure of the LES to