Info on Diagnostic tests for Achalasia?

Can anyone give me some insight on the testing and procedures done for diagnosing achalasia? and where is a good place to have them done?


You are facing testings? As I am from Europe I cannot provide you with names of hospitals etc. (well I’ve learned quite a lot on the Yahoo board, but I cannot locate the hospitals etc.).

As for the testings:
There is the barium X-ray. You need to drink some barium (thick white fluid, not ugly, not yummie, it’s in between) and they order you to swallow etc. while making pictures of your esophagus.

You can see some esophagus pictures of Achalasia cases at . The site is in German, but the pictures speak for themselves.

There is the manometry, where they enter your stomach with a very small (like a straw) tube through your nose. This tube has some manometres which measure the pressure of your esophagus muscles while swallowing (on command you need to swallow small amounts of water). With this test abnormalities in pressure can be found.

Then you have the gastroscopy. They enter your stomach with a tube (in my opinion quite a thick tube, I compare it to a water hose) through your mouth. You need to drink a little bit of fluid (not ugly and not yummie, again: in between) and then they enter your stomach with this tube. The tube has a camera and they can have a look in your esophagus and in your stomach. I would never never never have a gastroscopy without seditation. I had one without (my very first one, not knowing I had achalasia) and it was clear hell!!! They pushed the hose like hoppa through my narrow esophagus and it HURT!!! I have had soooo many (cannot even remember how many) afterwards, but only with seditation and that never hurts. I now never mind having a gastroscopy.

For as far as I know these are the most common testings for Achalasia.
Should you have any further questions, please ask.

Will you let us know what’s happening?


If you have not had any testing but you have all the symptoms a doctor usually will not test specifically for achalasia because you probably have something else.

The path to finding out you have achalasia generally involves testing for the usual suspects for the symptoms first. That means either a gastroscopy or barium swallow or both. Achalasia is easy to miss with the gastroscopy, but difficulty passing the scope through the lower esophageal sphincter and into the stomach is a clue that it could be achalasia. The barium swallow is where achalasia is usually first suspected or diagnosed. Then a manometry can be done to confirm or deny the diagnosis. Sometimes neither the gastroscopy or barium swallow leads to a diagnosis and the manometry is done to check for (often to rule out) any esophageal motility disorder not just achalasia.


Most likely they’ll do a barium swallow will doing the x-ray they watch how the barium flows through your esophagus and the appearance of a full esophagus under x-ray. If it has a “Bird’s Beak” appearance (becoming narrow at the entrance of the stomach) that’s one indicator of achalasia. The esophageal manometrics procedure (where they measure the actual contractions of the esophagus while swallowing) is considered the gold standard.

As far as test, most hospitals could probably do them. I would see a gastrologist with experience with achalasia first. From what I have learned over the years, the Cleveland Clinic in Ohio see’s more patients with achalasia in one week than most other hospitals see in a year, according to my physicians.

Good luck,