How does your doctor diagnose achalasia?
- Your doctor may have a suspicion that you have achalasia after taking your medical history.
- Further tests however are required and they include the following:
- Barium swallow which is an x-ray after swallowing a liquid which contains barium which shows up as a white shadow on an x-ray film.
- Oesophageal manometry which measures the pressure of contractions along the oesophagus using a thin plastic tube passed through the nose. In achalasia there are no contraction waves down the oesophagus but usually high pressure without relaxation at the lower oesophageal sphincter.
- Gastroscopy (panendoscopy) during which a specialist endoscopist passes a thin flexible viewing scope through the mouth to view the oesophagus and sphincter. This is usually done under sedation and is not painful or uncomfortable.
How can achalasia be treated?
- Medical therapy: Some medication can help in relaxing the lower oesophageal sphincter. This is usually not very successful and frequently only provides temporary relief.
- Mechanical stretching: The lower oesophageal sphincter can be stretched while performing a gastroscopy . A rubber tube or balloon is used for this.
- Botox injection: Botulinum toxin which causes temporary muscle relaxation can be injected into the lower oesophageal sphincter.
- Surgery is required in serious cases and is usually very successful.