Read the following medical record documentation and answer t…

Reаd the fоllоwing medicаl recоrd documentаtion and answer the question below. Gastroenterology Note. History of Present Illness: A 75-year-old female with history of dysphagia intermittent for two years. This morning, she complains of inability to swallow anything, including her saliva. She states onset was one day earlier while eating lunch. While enjoying beef stew, she suddenly noticed she could not finish her meal and since then has not been able to swallow anything. She is on Coumadin and her INR is 2.5. Operative Note: Informed consent was obtained from the patient. Daughter was also informed about the procedure and risks. Conscious sedation was administered with Versed 2 mg and fentanyl 50 mcg. Then, the scope was advanced into the esophagus. Liquid and solid particles were observed beginning at the mid-esophagus, reaching all the way to the distal esophagus. A meat bolus in the distal esophagus was visualized after clearing the liquid material and small particles of what appeared to be carrots. The patient, however, was not tolerating the conscious sedation. Hence, the anesthesiologist was brought in, and we continued the procedure with propofol sedation. The scope was reintroduced into the esophagus after propofol sedation. Initially, a Roth net was used, and some small amounts of soft food in the distal esophagus was removed with the Roth net. Then, a snare was used to cut the meat bolus into pieces, as it was very soft. Small pieces were grabbed with the snare and pulled out. Thereafter, the residual soft meat bolus was passed into the stomach along with the scope, which was passed between the bolus and the esophageal wall carefully. The patient had severe bruising and submucosal hemorrhage in the esophagus, possibly due to longstanding bolus impaction and Coumadin therapy. No active bleeding was seen. There was a distal esophageal stricture, which caused slight resistance to the passage of the scope into the stomach. As this area was extremely inflamed, a dilatation was not attempted. Impression: Distal esophageal stricture with food impaction. Treated as described above. Q: A diagnosis of dysphagia indicates the patient is having difficulty: