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1. Symptoms of achalasia include the following:
2. Laboratory studies are noncontributory. Studies that may be helpful include the following:

Dysphagia (most common)

Esophagogastroduodenoscopy to rule out cancer of the GEJ or fundus

Esophageal manometry (the criterion standard): Incomplete LES relaxation in response to swallowing, high resting LES pressure, absent esophageal peristalsis

Prolonged esophageal pH monitoring to rule out gastroesophageal reflux disease and determine if abnormal reflux is being caused by treatment

Chest pain

Weight loss

Heartburn

Regurgitation

Concomitant endoscopic ultrasonography if a tumor is suspected

Barium swallow: Bird’s beak appearance, esophageal dilatation