How is achalasia diagnosed?
Three tests are commonly used to diagnose achalasia: Barium swallow: For this test, you’ll swallow a barium preparation (liquid or other form) and its movement through your esophagus is evaluated using X-rays. The barium swallow will show a narrowing of the esophagus at the LES. Upper endoscopy: In this test, a flexible, narrow tube with a camera on it – called an endoscope – is passed down your esophagus. The camera projects images of the inside of your esophagus onto a screen for evaluation. This test helps rule out cancerous (malignant) lesions as well as assess for achalasia. Manometry: This test measures the timing and strength of your esophageal muscle contractions and relaxation of the lower esophageal sphincter (LES). Failure of the LES to relax in response to swallowing and lack of muscle contractions along the walls of the esophagus is a positive test for achalasia. This is the “gold standard” test for diagnosing achalasia.