Fact-sheet: Achalasia
Updated on 09/17/2021 at 12:16 PM
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Definition
Absence or insufficient relaxation of the lower Esophageal sphincter.
Workup (endoscopy and imaging) should rule out secondary megaesophagus (cardia cancer) and screen for complications (increased risk of esophageal squamous cell carcinoma, aspiration pneumonia)
Radiography
- Megaesophagus: dilatation of the Esophagus beginning in its upper third, then involving the entire Esophagus.
- Loss of primary peristalsis
- Non-peristaltic contractions
- Rat-tail or bird-beak-like narrowing, more pronounced at the esophagogastric junction
- Hurst phenomenon: temporary esophagogastric transit when the pressure of the Esophageal contrast column exceeds the tone of the lower Esophageal sphincter
- Sudden emptying after ingestion of a carbonated beverage or inhalation of a smooth muscle relaxant