EVALUATION OF ESOPHAGEAL ACHALASIA: FROM SYMPTOMS TO THE CHICAGO CLASSIFICATION

Rafael Melillo Laurino-Neto, Fernando Herbella, Francisco Schlottmann, Marco Patti, Rafael Melillo Laurino-Neto, Fernando Herbella, Francisco Schlottmann, Marco Patti

Abstract

Introduction: The diagnosis of achalasia may be suggested by clinical features but a complete work-up is required not only to confirm the diagnosis but also to grade the disease by severity or clinical subtype.

Objective: To review the current evaluation of esophageal achalasia and its correct comprehension.

Method: The literature review was based on papers published on Medline/Pubmed, SciELO and Lilacs, crossing the following headings: "esophageal achalasia"; "deglutition disorders"; "diagnostic techniques", "digestive system"; "endoscopy, digestive system"; "manometry".

Results: The diagnosis of achalasia is suggested by clinical features but is not sufficient to distinguish this from other esophageal disease. It must be confirmed by further diagnostic tests, such as esophagogastroduodenoscopy, barium swallow and manometry. Recent advances in diagnostic methods, including high resolution manometry might even help predicting outcome or selected more appropriate procedures to treat the disease.

Conclusion: A detailed and systematic study of achalasia patients allows not only a correct diagnosis but also contributes to therapeutic decision making and prognosis.

Conflict of interest statement

Conflict of interest: none

Figures

FIGURE 1. Barium swallow in achalasia (proximal…
FIGURE 1. Barium swallow in achalasia (proximal dilated esophagus, distal taper- arrow)
FIGURE 2. Conventional manometry in a case…
FIGURE 2. Conventional manometry in a case of achalasia
FIGURE 3. Achalasia subtypes in high resolution…
FIGURE 3. Achalasia subtypes in high resolution manometry

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