When should I consider referring a patient with achalasia to a specialist for further management?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

You should consider referring a patient to a gastroenterologist or upper gastrointestinal surgeon for specialist investigations and management if they present with gastro-oesophageal symptoms that are refractory to treatment, persistent, or unexplained . Specialist investigations, such as oesophageal manometry and barium swallow, are undertaken in these settings to help exclude oesophageal motility disorders like achalasia .

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