Sandbox: achalasia

DD

GERD

Retrosternal burning chest pain. Cough and hoarseness of voice. May present with complications such as strictures and dysphagia.
Upper GI endoscopy shows the complications such as esophagitis and barret esophagus. Esophageal manometry may show decreased tone of the lower esophageal sphincter. 24-hour esophageal pH monitoring may be done to confirm the diagnosis.

Esophageal Cancer

• Dysphagia
• Odynophagia- fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty
• Weight loss
• Pain, often of a burning nature, may be severe and worsened by swallowing, and can be spasmodic in character
• Nausea and vomiting

Upper GI endoscopy and bioEsophageal biopsy the gold standard for the diagnosis of esophageal

Nutcracker esophagus

• Retrosternal chest pain that presents with or without food.
• The condition is not progressive and not causing complications.

Barium swallow shows the characteristic corckscrew appearance of the esophagus.

Esophageal stricture

• Patient may present with the symptoms of the underlying GERD.
• Dysphagia and odynophagia.

• Barium esophagography provides information about the site and the diameter of the stricture before the endoscopic intervention.

	Manifestations	Diagnostic tools
GERD	Retrosternal burning chest pain. Cough and hoarseness of voice. May present with complications such as strictures and dysphagia.	Upper GI endoscopy shows the complications such as esophagitis and barret esophagus. Esophageal manometry may show decreased tone of the lower esophageal sphincter. 24-hour esophageal pH monitoring may be done to confirm the diagnosis.
Esophageal carcinoma	Dysphagia Odynophagia- fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty Weight loss Pain, often of a burning nature, may be severe and worsened by swallowing, and can be spasmodic in character Nausea and vomiting	Upper GI endoscopy and esophageal biopsy the gold standard for the diagnosis of esophageal
Corckscrew esophagus	Retrosternal chest pain that presents with or without food intake. The condition is not progressive and not causing complications.	Barium swallow shows the characteristic corckscrew appearance of the esophagus.
Esophageal stricture	Patient may present with the symptoms of the underlying GERD. Dysphagia and odynophagia.	Barium esophagography provides information about the site and the diameter of the stricture before the endoscopic intervention.