Case Scenario: A 22-year-old male patient presented with complaints of heartburn and regurgitation due to suspect of gastroesophageal reflux. He had a 10-year history of retrosternal burning and was taking omeprazole 20 mg tablet once daily. He reported intermittent solid-food dysphagia 2 years back. The physical examination results were unremarkable. The patient’s esophagogastroduodenoscopy (EGD) revealed normal Esophageal mucosa.
Owing to the persistent symptoms, the patient was subjected to an Esophageal High-Resolution Manometry (HRM). The test findings are depicted in the table. HRM Parameters Findings Reference Values Integrated relaxation pressure 28.2 mm Hg < 15 mm Hg Intact swallows % 0 > 50 Failed swallows % 100 < 50 Table: Patient HRM Rest Results Which of the following would be the next diagnostic approach? Option A: Perform 360-degree (Nissen) fundoplication Option B:…
