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Question category: Gastroenterology

A 45 year old female, known to have systemic sclerosis presents at clinic with worsening reflux, abdominal bloating and is also having bouts of diarrhoea and constipation. She is currently on omeprazole. On examination her abdomen is soft but is tender generally. A motility study is performed and shows severe oesophageal dysmotility and a hydrogen breath test is positive. How would you manage this patient?

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