• Home
• Symptoms
• Treatment
• News
• Links

What are the symptoms?

• Difficulty swallowing (dysphagia). This is the most common symptom. Patients typically describe a feeling of food ‘sticking in the chest’. Dysphagia occurs with both solid and liquid food and is occurs during every meal.
• Chest pain. Sometimes patients describe a heavy sensation in their chest after eating, which may be mistaken for cardiac pain.
• Regurgitation of food. If the regurgitation happens during sleep, food can enter the throat causing coughing and choking. If the food enters the lungs, it can cause a type of pneumonia called an aspiration pneumonia.
Because of the dysphagia and regurgitation, weight loss frequently occurs.

How is achalasia diagnosed?

Because patients typically learn to compensate for their dysphagia by taking smaller bites, chewing well, and eating slowly, the diagnosis of achalasia often is delayed by months or even years.

The following investigations are usually done:

Barium swallow. Barium (a special liquid that shows up on x-ray) is swallowed and the progress of the barium through the oesophagus is observed on video.
In achalasia, the oesophagus may appear dilated, and barium passes slowly into the stomach. The lower end of the oesophagus is narrowed and tapered and is often described as resembling a bird's beak.

Oesophageal manometry. A thin tube that measures the pressure generated by the contracting oesophageal muscle is passed through the nose, down the back of the throat and into the oesophagus. In achalasia, no peristaltic waves are seen in the lower half of the oesophagus after swallows, and the pressure within the contracted lower oesophageal sphincter does not fall with the swallow. Manometry is particularly useful for diagnosing early achalasia.

Endoscopy. A flexible fibreoptic tube with a light and camera on the end is swallowed. The inside of the oesophagus can then be viewed. Resistance as the tube is passed from the oesophagus into the stomach may be an early indicator of achalasia. Later, endoscopy may show a dilated oesophagus and a lack of peristaltic waves. Endoscopy will also exclude the presence of oesophageal cancer.