<prompt> A 50-year-old gynecologist complains of dysphagia, regurgitation, and weight loss. She also states that she feels as if food is stuck at the level of the xiphoid. An upright chest x-ray shows a dilated esophagus with an air-fluid level. Which of the following is FALSE?A barium swallow will show a birds beak deformityManometry will demonstrate that the LES fails to relax during swallowing.Upper endoscopy should be avoided because of the risk of complications.Medical treatment includes nitrates and calcium channel blockers.  <response>: The symptoms and radiologic findings in this patient suggest achalasia. Evaluation includes endoscopy to rule out a stricture or cancer. Barium swallow will show a dilated esophagus, failure of the LES to relax during swallowing, and a lack of peristalsis. Nonoperative management is of limited usefulness but may be considered in high-risk patients who are not candidates for surgery. 