What is the definition of “achalasia”?
Achalasia is a motility disorder of the esophagus. Idiopathic · changes · esophageal cancer · Loss of Inhib. Neurons in Auerbach's · swallowing = Peristalsis + LES (relax) via Inhib Neurons (NO + VIP) · Damaged Neurons = No peristalsis + hypertonic LES
Characterized by failure of the lower esophageal sphincter to relax in response to swallowing and by an absence of peristalsis in the esophageal body.
The disease is often more progressive leading to gradual dilation of the esophagus above the sphincter.
What is the classic triad of presenting symptoms in achalasia?
The classic triad of presenting symptoms in achalasia consists of:
Two studies are used for the diagnosis of achalasia. Which are they?
The diagnosis of Achalasia is usually made from barium esophagram and a motility study.
The esophagram will show a dilated esophagus with a distal narrowing referred to as the classic “birds beak” appearance of the barium filled esophagus.
Which is the gold standard test for differentiation between achalasia and other potential esophageal motility disorders?
Manometry is the gold standard test that will help differentiation between Achalasia and other potential esophageal motility disorders.
Esophageal manometry → confirms the clinical diagnosis.
4 Criteria are characteristic of Achalasia:
- Elevated (↑) lower esophageal sphincter pressure
- Incomplete or absent relaxation of the lower esophageal sphincter in response to swallowing.
- Absence ⓧ of peristalsis in the Esophageal body
- Elevated (↑) intraesophageal pressure