Center for Minimally Invasive Esophageal Therapies
Diseases & Conditions
Achalasia – Diagnostic Procedures
How is Achalasia Diagnosed?
Diagnosis is usually made as a result of one or more of the following tests:
The physician will spray a pain-killing solution in your throat and then examine the area using an endoscope, which is a thin, lighted tube with a tiny camera at the end. He or she will be able to see any abnormalities and take a tissue sample (biopsy), if necessary. You may be given medication through a vein if you are having trouble relaxing.
If achalasia is suspected you may be asked to be on a clear liquid diet for 2-3 days before endoscopy. This is to minimize risk of aspiration.
This test measures the pressure inside the lower esophageal sphincter (LES). A thin tube is inserted through your mouth or nose and into your stomach. Once it is in place, the physician will gently pull the tube back into the esophagus and ask you to swallow. As you do so, the pressure and coordination of your muscle contractions will be measured. If the pressure is low or the LES is not relaxing properly, achalasia may be present.
Esophagram (or Barium Swallow)
For an esophagram (also called a barium swallow) you will drink a barium-containing liquid, which coats the inside of the esophagus and makes its shape and contours appear on x-rays. As the liquid moves from the mouth down to the esophagus, the physician can assess any narrowing, enlargement or abnormalities. You will most likely be asked not to eat or drink for 8 to 10 hours before the test.