Achalasia Diagnosis

High resolution oesophageal manometry. This is the standard test to diagnose achalasia as it is the only one where the movement of the oesophagus and the relaxation of the lower oesophageal sphincter can be studied. A probe with pressure sensors is inserted through the patient's nose and the movement of the oesophagus is observed while liquids and solids are administered through the mouth. The complete absence of oesophageal movement and lack of valve relaxation confirm the diagnosis of achalasia.

Gastroscopy. This is a test that is used to rule out other diseases that also cause obstruction of the oesophagus.

Oesophagram. This is a test to evaluate if there is dilation or external compression of the oesophagus, as well as if the disease has been evolving for a long time. 

EndoFLIP with planimetry. This is a novel technique that evaluates the movements of the oesophagus, as well as the distension and diameter of the lower oesophageal sphincter. The test provides information both for diagnosis and to evaluate the type of treatment most indicated: surgical or peroral endoscopic myotomy (POEM) of the lower oesophageal sphincter. This test is also recommended when the patient cannot tolerate the insertion of an oesophageal manometry probe or when the gastric cavity cannot be accessed to evaluate the oesophagogastric junction, due to oesophageal dilation.