Intended for healthcare professionals

Minerva Minerva


BMJ 2003; 326 doi: (Published 01 March 2003) Cite this as: BMJ 2003;326:508

An 80 year old woman had had difficulty in swallowing solids for a few months. The food tended to get stuck in the retrosternal area. Eating food slowly and having a glass of water helped. She also had occasional spasmodic retrosternal pain, usually after eating, but denied having symptoms of gastro-oesophageal reflux. Endoscopy showed normal oesophageal mucosa with increased oesophageal contractions. Barium swallow in the prone position showed marked tertiary contractions within the oesophagus with no effective peristalsis. In the erect position the barium passed slowly into the stomach. The appearances are those of a corkscrew oesophagus due to oesophageal dysmotility.

V Goel, specialist registrar in gastroenterology, T R Yapp, consultant gastroenterologist, R Clements, consultant radiologist, Royal Gwent Hospital, Newport NP20 2UB

Tamoxifen reduces the risk of breast cancer by about 50% in women at high risk. It also protects these women against benign breast disease, according to a new study (Journal of the National Cancer Institute 2003;95:302-7). Women who took tamoxifen in the original breast cancer prevention trial were 28% less likely than controls to get benign breast disease, and 29% less likely than controls to need a breast biopsy during an …

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