Which imaging study is recommended for a patient with chronic GERD who develops difficulty swallowing?

For a patient with chronic gastroesophageal reflux disease (GERD) who develops difficulty swallowing, the recommended imaging study is an esophagogastroduodenoscopy (EGD), commonly referred to as an upper endoscopy. This procedure allows direct visualization of the esophagus, stomach, and the beginning of the small intestine. It is particularly useful for assessing structural abnormalities or complications related to GERD, such as esophagitis, strictures, or Barrett's esophagus.

EGD not only provides diagnostic information but also allows for intervention if necessary, such as dilation of strictures or biopsy of abnormal areas for histological examination. This is critical in a patient with new onset dysphagia, as it can help differentiate between benign and malignant causes of swallowing difficulties associated with chronic GERD.

Other imaging modalities listed have specific utilities but do not directly investigate the esophagus as thoroughly as EGD does. X-rays of the chest may reveal some structural abnormalities but lack the detail needed to assess mucosal surface changes or intraluminal issues. A CT scan of the abdomen could provide information about the surrounding structures but is not sufficient for observing the esophageal lining or diagnosing conditions related directly to GERD. An ultrasound of the neck could potentially evaluate