Achalasia: Clinical Presentation and Evaluation

Although esophageal achalasia is a rare disease, it represents the most common primary esophageal motility disorder. It is characterized by a manometric pattern showing loss of esophageal peristalsis and partial or absent relaxation of the lower esophageal sphincter (LES) in response to swallowing. Consequently, there is abnormal emptying of food from the esophagus into the stomach resulting in stasis. Most patients experience severe dysphagia and regurgitation that can lead to aspiration and respiratory problems and weight loss. As a consequence, the quality of life of patients with achalasia is severely affected. The diagnosis of achalasia can be challenging due to nonspecific symptoms and therefore a proper work-up is necessary to establish the diagnosis before starting treatment.