ABSTRACT
A family doctor refers you a 12-year-old boy, whom he suspects has an esophageal stricture. The patient was well until age 9 when he started experiencing regurgitation and heartburn. He was treated empirically for gastroesophageal reflux disease (GERD), first with H2-blockers, then with proton pump inhibitors. He was lost to follow-up for more than 2 years before returning to his family doctor with worsening symptoms and significant weight loss. His parents had stopped the GERD treatment because they did not feel it was helping him. His doctor ordered the study shown in Figure 24.1, which he interpreted as a stricture due to noncompliance with treatment.
