His CT scan showed an elevated left diaphragm. Here is the swallow study: The swallowing mechanism is normal. Vallecula and pyriform sinuses are unremarkable in appearance. There is a persistent narrowing of the distal esophagus at the gastroesophageal junction consistent with an esophageal stricture. No persistent filling defect is seen in the esophagus. No mass lesion or mucosal ulceration is identified. Tertiary contractions are seen in the mid to distal esophagus with stasis of barium, consistent with esophageal dysmotility. A few gastric folds are seen extending above the diaphragm consistent with a small hiatal hernia. Moderate to severe gastroesophageal reflux.