The key clinical features that suggest a diagnosis of achalasia in a patient presenting with dysphagia are primarily derived from the nature of the dysphagia itself and associated symptoms Wilkinson & Halland 2020. Achalasia is a primary esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent esophageal peristalsis Wilkinson & Halland 2020. Patients typically experience progressive dysphagia to both solids and liquids Wilkinson & Halland 2020. This dysphagia is often long-standing, evolving over months to years Wilkinson & Halland 2020. Other common symptoms include regurgitation of undigested food, which can lead to nocturnal cough or aspiration Wilkinson & Halland 2020. Patients may also report chest pain and significant weight loss due to difficulty eating Wilkinson & Halland 2020. While heartburn or pyrosis can occur, it is often due to food stasis rather than acid reflux Wilkinson & Halland 2020.
Key References
- CG184 - Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
- CKS - Dyspepsia - proven GORD
- NG231 - Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management
- NG1 - Gastro-oesophageal reflux disease in children and young people: diagnosis and management
- (Abubakar et al., 2016): Pseudoachalasia: A review.
- (Wilkinson and Halland, 2020): Esophageal Motility Disorders.
- (Pesce et al., 2023): Modern Achalasia: Diagnosis, Classification, and Treatment.