What is achalasia?

I. Pathophysiology: A. Absence of relaxation of the LES upon swallowing B. Simultaneous peristalsis in the esophageal body C. The intraluminal pressure increase and the body of the esophagus becomes dilated This due to neurogenic degeneration (autoimmune,genetic, infectious such as chagas disease caused by Trypanosoma cruzi) II. Symptoms : Dysphagia, regurgitation and weight loss. Respiratory symptoms caused by aspiration may be present. III. Diagnosis: A. Radiographic studies: typically reveal a dilated mid-esophagus with a “bird’s beak” appearance of the lower esophagus. B. Esophageal manometry: shows absence of peristalsis C. Esophagoscopy: Required to rule out cancer and to document the extent of esophagitis. Retained food is commonly found at endoscopy, and the LES may be difficult to traverse.