While upper GI endoscopy and barium esophagrams will likely be performed to rule out other causes of your symptoms including gastroesophageal reflux disease (GERD) and esophageal cancer and stomach cancer, the best test to diagnose Achalasia is an esophageal manometry. A small tube is passed down the patient's nose and into the stomach. As it is slowly pulled back up into the esophagus, you will be asked to swallow small sips of water and the tube will measure the pressures in your esophagus to assess the strength and coordination of contractions of the esophageal muscles.

Achalasia Treatment

The treatment of Achalasia falls into three categories:

• Pneumatic dilation. This involves placing a balloon in the esophagus and forcefully expanding it, tearing the muscles of the valve so that the valve no longer obstructs passage of food from the esophagus into the stomach. This has a 75% chance of relieving symptoms for a period of years, but has a 3% risk of rupturing the esophagus. If esophageal rupture occurs, then emergency surgery is necessary to repair the rupture and then treat the achalasia surgically.
• BoTox Injection. Injected into the esophagus, the BoTox paralyzes the muscles of the valve between the esophagus and stomach, permitting food to pass from the esophagus into the stomach. Over 60% of people who have this therapy get substantial relief of symptoms for at least one year. Both of these procedures are done via an upper GI endoscopy.
• Surgery. At surgery, the muscles of the valve between the esophagus and stomach are cut, permitting food to pass from the esophagus into the stomach. Since the early 1990s the operation has been done laparoscopically, allowing patients to go home much earlier, often the day after surgery. Almost 95% of patients who have surgery for achalasia experience relief of symptoms for many years after the operation.

If you are diagnosed with Achalasia, you should discuss with your doctor which treatment option is best for you. Remember to speak with your physician about your symptoms and treatments. My blog is not for individual treatment or practice.

Read more from Dr. Eisner on Achalasia 

We hope you find this general medical and health information useful, but this Q&A is meant to support and NOT replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor.