Achalasia

Key points

• Failure of oesophageal peristalsis and of relaxation of lower oesophageal sphincter (LOS) due to degenerative loss of ganglia from Auerbach's plexus i.e. LOS contracted, oesophagus above dilated.
• dysphagia of BOTH liquids and solids
• typically variation in severity of symptoms
• regurgitation of food - may lead to cough, aspiration pneumonia etc
• malignant change in small number of patients Investigations