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November 13, 1967

Achalasia of the Esophagus: Diagnosis and Treatment

Author Affiliations

From the Department of Medicine (Division of Gastroenterology) and the Joseph B. Whitehead Department of Surgery (Division of Thoracic and Cardiovascular Surgery), Emory University School of Medicine. Atlanta.

JAMA. 1967;202(7):620-623. doi:10.1001/jama.1967.03130200106019

Achalasia of the esophagus is characterized by lack of neuromuscular coordination, which results in an absence of normal peristalsis in the body of the esophagus and a failure of relaxation of the lower segment. It is a frequent cause of esophageal obstruction. Symptoms of achalasia include dysphagia, regurgitation (nocturnal overflow), substernal discomfort, recurrent pulmonary infection, and weight loss. The diagnosis of achalasia is established by esophagoscopy, x-ray examinations (routine posterioanterior and lateral views), barium swallow and cinefluoroscopy, and esophageal motility studies. Treatment consists of bougienage, forceful dilation, and Heller esophagocardiomyotomy.