A 15-year-old girl presented with feeding intolerance and failure to thrive. One year prior to presentation, she developed difficulty consuming solids, with painful choking episodes upon swallowing, followed by emesis. The mother reported she had performed the Heim-lich maneuver during some of the patient's more severe choking episodes. She transitioned her daughter to pureed foods, which she tolerated for 1 month. At the time of presentation, the patient was able to tolerate only liquids, including 16 oz each of Pedialyte, PediaSure, and papaya nectar daily. The patient's pediatrician had prescribed both ranitidine and omeprazole for potential reflux without significant improvement.
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