A high tone lower esophageal sphincter (LES) is indicative of which condition?

A high tone lower esophageal sphincter (LES) is indicative of achalasia, as this condition is characterized by an inability of the LES to relax appropriately during swallowing. In achalasia, there is a loss of ganglion cells in the myenteric plexus, leading to increased resting tone of the LES. This results in difficulty swallowing, regurgitation of undigested food, and sometimes chest pain. The high resting tone of the LES reflects the dysfunction that prevents proper transit of food from the esophagus into the stomach.

Gastroesophageal reflux disease (GERD) is typically associated with a lower tone of the LES, contributing to reflux. Esophageal cancer can present with swallowing difficulties, but it does not primarily cause an increase in tone of the LES. Esophagitis involves inflammation of the esophagus, which is not directly related to the tone of the LES. Therefore, achalasia is the primary condition linked to a high tone LES, highlighting the importance of understanding the underlying physiological changes associated with various esophageal conditions.