Diagnosis of Achalasia

ABSTRACT

Achalasia is a rare primary motor disorder of the esophagus. Achalasia is characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. The patients present with symptoms such as dysphagia, regurgitation and chest pain. The diagnostic tools of achalasia include esophageal manometry, esophagogram, and endoscopy. Esophageal manometry is the gold standard however endoscopy and esophagogram plays complementary roles for diagnosis of achalasia. Endoscopy is essential to rule out pseudoachalasia and mechanical obstruction before diagnosis of achalasia. Esophagogram is recommended to assess esophageal emptying and gastroesophageal junction morphology in those with equivocal esophageal manometry findings.