The patient’s symptoms are all associated with increased portal hypertension: increased pressure that impedes blood flow through any part of the vena cava, or portal venous system. The blood pools and increases pressure within the veins resulting in collateral veins that are distended and tortuous, called varices. Esophageal varices can rupture due to increased venous pressure and erosion by gastric acid. Vomiting from bleeding or ruptured esophageal varices is the most common clinical manifestation of portal hypertension. Achalasia refers to a disordered esophageal sphincter that cannot fully relax. Gastric ulcers and esophageal cancers may cause hematemesis, but portal hypertension is the most likely diagnosis for this patient.