Achalasia

Diagnosis

Other conditions may be confused with achalasia. Mayo has many tools to help make an accurate diagnosis. Your doctor typically will start by asking you about the history of your problem and performing a physical examination. Three tests especially may be recommended:

• Barium X-ray. You drink a barium solution to help better visualize the esophagus. In people who have achalasia, the X-ray shows a dilated (enlarged or widened) esophagus, with a characteristic narrowing of the lower end resembling a bird's beak. In addition, the barium stays in the esophagus longer than normal before passing into the stomach.
• Endoscopy. A thin, flexible tube (endoscope) which contains a camera is passed down the throat. Endoscopy is recommended to rule out esophageal cancer, which can obstruct the passage of food and dilate the esophagus.
• Esophageal manometry. A thin tube is inserted into the esophagus and connected to a pressure recorder, which measures muscle contractions of the esophagus when you swallow. Typically, no pressure waves appear in the lower half of the esophagus after a swallow in people with achalasia. An advantage of manometry is that it can diagnose achalasia in its early stages.

Read more about endoscopy and esophageal manometry on MayoClinic.com.