How is Achalasia diagnosed?

How is Achalasia diagnosed?

Achalasia is a rare disorder that affects the esophagus, the tube that carries food from the mouth to the stomach. It occurs when the lower esophageal sphincter (LES), a muscular ring at the bottom of the esophagus, fails to relax properly during swallowing. This leads to difficulty in moving food down into the stomach and can cause symptoms such as regurgitation, chest pain, and difficulty swallowing.

Diagnosing achalasia can be challenging as its symptoms can be similar to other conditions. However, there are several diagnostic tests that can help confirm the presence of achalasia and rule out other potential causes.

1. Medical History and Physical Examination: The first step in diagnosing achalasia is a thorough medical history and physical examination. The doctor will ask about your symptoms, their duration, and any factors that worsen or alleviate them. They will also perform a physical examination to check for any signs of esophageal abnormalities.

2. Barium Swallow Test: One of the most common tests used to diagnose achalasia is a barium swallow test, also known as an esophagram. During this test, you will be asked to drink a liquid containing barium, which coats the lining of the esophagus and makes it visible on X-rays. X-ray images are then taken as you swallow the barium. This test can show the characteristic narrowing of the lower esophagus and the absence of normal peristalsis (muscle contractions) in achalasia.

3. Esophageal Manometry: Esophageal manometry is a diagnostic test that measures the pressure and coordination of muscle contractions in the esophagus. It involves inserting a thin, flexible tube through the nose or mouth and into the esophagus. The tube contains sensors that detect the pressure exerted by the esophageal muscles during swallowing. In achalasia, the lower esophageal sphincter fails to relax properly, and the esophageal contractions are weak or absent.

4. Endoscopy: An endoscopy may be performed to visualize the inside of the esophagus and rule out other potential causes of symptoms. During this procedure, a thin, flexible tube with a camera on the end (endoscope) is inserted through the mouth and into the esophagus. The doctor can examine the esophageal lining for any abnormalities or signs of inflammation.

5. Other Tests: In some cases, additional tests may be required to confirm the diagnosis or assess the severity of achalasia. These may include esophageal pH monitoring to measure acid reflux, CT scans to evaluate the esophageal structure, or biopsy to rule out other conditions.

Once a diagnosis of achalasia is confirmed, appropriate treatment options can be discussed with your healthcare provider. It is important to consult a medical professional for an accurate diagnosis and personalized treatment plan.