Diagnosing Achalasia requires a Barium Swallow, Endoscopy, & High-Resolution Manometry (HRM). Learn about tests, preparation, and how results classify your condition.
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Diagnosing Achalasia is a step-by-step process that confirms the lack of proper muscle function in the esophagus and rules out other diseases. The diagnostic journey starts with basic screening tests and progresses to advanced procedures like manometry, which is essential for accurately classifying the disease and guiding treatment.
While there are no routine screening tests for the general public, the following procedures are often the first steps taken when a patient presents with classic symptoms like dysphagia (difficulty swallowing) and regurgitation.
The Barium Swallow is typically the first imaging test ordered to evaluate the structure and function of the esophagus.
Upper Endoscopy is a vital procedure used to directly examine the lining of the upper gastrointestinal tract.
If the initial screening tests suggest achalasia, the diagnosis must be confirmed and classified using High-Resolution Manometry.
HRM is the gold standard for diagnosing achalasia, as it directly measures the pressure and coordination of the esophageal muscles.
Proper preparation ensures the safety and accuracy of these diagnostic tests.
Once both the EGD rules out a tumor, and the HRM confirms aperistalsis and elevated IRP, the diagnosis of achalasia is certain.
You need advanced esophageal function testing (HRM) when initial screening tests, like the Barium Swallow, show clear functional problems, but a definitive, classified diagnosis is needed before planning definitive treatment (surgery or dilation). HRM is essential because it is the only test that can distinguish achalasia from other similar motility disorders like Diffuse Esophageal Spasm.
Send us all your questions or requests, and our expert team will assist you.
The primary diagnostic tests are the Barium Swallow (which shows the characteristic “bird’s beak” narrowing), Upper Endoscopy (EGD) (to rule out tumors), and High-Resolution Manometry (HRM), which is the gold standard for measuring muscle function and classifying the disease type.
You must fast (no food or drink) for at least 6 to 8 hours before both procedures. For Endoscopy, you may be asked to follow a clear liquid diet the day before to clear any retained food from the esophagus.
HRM is generally not painful, but it can be uncomfortable. The main discomfort comes from the sensation of the thin catheter being passed through the nose and throat. The procedure is performed without sedation and lasts about 15 to 30 minutes.
High-Resolution Manometry (HRM) is highly accurate (considered the gold standard), providing objective data on muscle failure and sphincter pressure. The Barium Swallow is also highly accurate when showing the classic “bird’s beak” sign.
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