, 15:358
Date: 17 Nov 2013

The American College of Gastroenterology’s New Guidelines on Achalasia: What Clinicians Need to Know

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Achalasia is an uncommon but one of the classic esophageal motility disorders defined based on manometric findings in the classic setting of dysphagia [1]. Although the etiology of the disease is currently unknown, it is established that the disease entity affects esophageal peristalsis and the lower esophageal sphincter relaxation resulting in chronic symptoms. The most common presenting symptoms of patients with achalasia are dysphagia to solids and liquids as well as regurgitation. However, patients may over-emphasis regurgitation as a predominant symptom leading to mis-diagnosis of reflux disease [2]. Patients may also complain of accompanying chest pain, but this symptom is often associated with the sensation of difficulty with food emptying. Weight loss is less common but, if significant, should lead to suspicion of pseudoachalasia due to malignancy. Several important clinical pearls, which may help the healthcare provider in timely diagnosis of achalasia, are outlined below: