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  1. Mark Fox, specialist registrar (markfox@doctors.org.uk)1,
  2. Alasdair Young, senior house officer2,
  3. Roy Anggiansah, physiologist1,
  4. Angela Anggiansah, director1,
  5. Jeremy Sanderson, consultant2
  1. 1 Oesophageal Laboratory, St Thomas' Hospital, London SE1 7EH
  2. 2 Department of Gastroenterology, St Thomas' Hospital
  1. Correspondence to: MFox
  • Accepted 5 January 2006

This is the first of a three part case report where we invite readers to take part in considering the diagnosis and management of a case using the rapid response feature on bmj.com. Next week we will report the case progression and in four weeks' time we will report the outcome and summarise the responses.

Kenneth Neville is a 22 year old student who presented to his general practitioner at the age of 18 with regurgitation and vomiting after meals. These symptoms became a recurrent problem, but laboratory investigations including full blood count and renal and liver function tests gave normal results. …

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