Rapid Review: Achalasia

August 7, 2017


  • Patient will complain of dysphagia to solids and liquids
  • PE will show absent peristalsis in lower esophagus
  • Barium swallow shows “bird beak” appearance
  • Diagnosis is made by esophageal manometry increased LES pressure

Sample question:

A 60-year-old man comes to the clinic complaining of difficulty swallowing, heartburn, chest pain, and mild weight loss. He has difficulty swallowing solids and liquids and often regurgitates undigested food. He has no past medical history and takes no medications. He denies any recent travel. Esophageal manometry reveals aperistalsis in the distal two-thirds of the esophagus and incomplete lower esophageal sphincter (LES) relaxation. Which of the following is the most likely diagnosis?

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