Achalasia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Physical examination is usually non significant as the diagnosis is dependent on the symptoms and the radiological tests. Patients with achalasia usually appear calm and in no acute stress. Physical examination of patients with achalasia is usually remarkable for weight loss and oral cavity ulcers.

Physical Examination

Appearance

Patients with achalasia usually appear calm and in no acute distress.

General

  • Achalasia patients may have low BMI due to chronic weight loss.[1]

Vital signs

  • Achalasia patients are usually vitally stable.

Head and neck

  • Oral cavity examination may show ulcers due to food regurgitation.[2]
  • Lungs usually show clear vesicular breathing sounds, with equal air entry.

Abdomen

  • Abdomen is usually lax, non tender, and with no masses

Heart

  • On auscultation, the heart has normal S1, S2, with no rubs, gallops, nor murmers.

Extremities

  • Extremities may show emaciation especially in chronic cases.

Neurologic

  • Patient is usually oriented to time, person, and place with good motor and sensory functions.

References

  1. Kempf J, Beckmann K, Kook PH (2014). "Achalasia-like disease with esophageal pressurization in a myasthenic dog". J. Vet. Intern. Med. 28 (2): 661–5. doi:10.1111/jvim.12329. PMC 4857995. PMID 24612067.
  2. Stone ML, Kilic A, Jones DR, Lau CL, Kozower BD (2012). "A diagnostic consideration for all ages: pseudoachalasia in a 22-year-old male". Ann. Thorac. Surg. 93 (1): e11–2. doi:10.1016/j.athoracsur.2011.07.064. PMC 3278770. PMID 22186482.

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