Achalasia

Achalasia - Diagnosis

How is achalasia diagnosed?

Three tests are performed to diagnose achalasia. They are:

(a) Endoscopy (oesophagogastroduodenoscopy)

A flexible scope is passed into the oesophagus to rule out other causes of dysphagia such as tumours/growths.

(b) Barium swallow

A specialised x-ray of the passage of the swallowed barium down the oesophagus.

(c) High resolution manometry

A test that measures the pressure, timing and contractions of the oesophagus as well as the lower oesophageal sphincter relaxation.
It helps to confirm and determine the subtype of achalasia.

General Surgery,

Upper Gastrointestinal

Article contributed by Upper Gastrointestinal ＆ Bariatric Surgery, Changi General Hospital; Upper Gastrointestinal ＆ Bariatric Surgery, Singapore General Hospital

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

Clin Assoc Prof Christopher Khor Jen Lock

MBBS, FRCP (Edin), FAMS, FASGE

Clinical Interests: Advanced Endoscopic Imaging, Diagnostic and Therapeutic Endoscopy, Gastrointestinal Stenting, Endoscopic Ultrasound (EUS), Endoscopic Retrograde Cholangio-Pancreatography (ERCP), Colon Cancer Screening, Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD), Endoscopic Therapy of early Gastrointestinal Cancer, Peroral Endoscopic Myotomy (POEM), Pancreaticobiliary Disorders

Clin Asst Prof Vikneswaran N

Senior Consultant

MBBS (Spore), MRCP(UK), FAMS

Clinical Interests: Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD), Irritable Bowel Syndrome and Motility Disorders, Early Gastrointestinal Cancers ＆ Dysplasia, Diagnostic and Therapeutic Endoscopy, Advanced Endoscopic Imaging, Gastroesophageal Reflux Disease (GERD)

TOP

[{"SHPageId":"1031","BodyPart":"#Colon#, #Pancreas#","BodyPartLst":["colon","pancreas"],"Institution":null,"SHDoctorConditionsTreatments":"#Early Cancer of the Esophagus, Stomach ＆ Colon#, #Colon Cancer Screening#, #Colonic Polyps#, #Complex Colonic Polyps#, #Pancreatic Cysts ＆ Nodules#, #Biliary Stones (Choledocholithiasis)#, #Pancreatic ＆ Hepatobiliary Cancer#, #Subepithelial/Submucosal Lesions#, #Gastrointestinal Luminal Stenosis#, #Achalasia#, #General Gastroenterology#","SHDoctorConditionsTreatmentsLst":["early cancer of the esophagus, stomach ＆ colon","colon cancer screening","colonic polyps","complex colonic polyps","pancreatic cysts ＆ nodules","biliary stones (choledocholithiasis)","pancreatic ＆ hepatobiliary cancer","subepithelial/submucosal lesions","gastrointestinal luminal stenosis","achalasia","general gastroenterology"],"SHDoctorAwards":null,"SHDoctorAwardsFullHtml":null,"SHDoctorClinicalDesgDisp":"","SHDoctorClinicalDesgInstText":"48d80a29-eabe-421e-aa61-202648168f9e|8e9834e6-3ccb-4ee2-bdb9-45837e8602f8;Senior Consultant|8e9834e6-3ccb-4ee2-bdb9-45837e8602f8;","ListSHDoctorClinicalDesgInst":[{"ClinicalDesgName":"Senior Consultant","ClinicalDesgId":"48d80a29-eabe-421e-aa61-202648168f9e","ClinicalDesgInst":"Singapore General Hospital","ClinicalDesgInstId":"8e9834e6-3ccb-4ee2-bdb9-45837e8602f8"}],"ListSHDoctorClinicalDesg":null,"SHDoctorClinicalDesgInstFirst":"Senior Consultant","SHDoctorAltDesgDisp":"","SHDoctorEducation":null,"SHDoctorEducationFullHtml":null,"SHDoctorProfile":null,"SHDoctorProfileFullHtml":null,"SHDoctorResearchInterests":"\u003cul\u003e\u003cli\u003ePancreato-biliary endoscopy\u003c/li\u003e\u003cli\u003ePathogenesis and Endoscopic therapy of early gastrointestinal malignancy\u003c/li\u003e\u003cli\u003eMedical device development\u003c/li\u003e\u003c/ul\u003e","SHDoctorResearchInterestsFullHtml":null,"SHDoctorResearchTrials":null,"SHDoctorResearchTrialsFullHtml":null,"SHDoctorProfAppointments":null,"SHDoctorProfAppointmentsFullHtml":"\u003cul\u003e\u003cli\u003e\u003cspan style=\"font-size\u0026#58;13px;\"\u003eAdjunct Associate Professor, Duke-NUS Medical School\u003c/span\u003e\u003cbr\u003e\u003c/li\u003e\u003cli\u003eClinical Senior Lecturer, Yong Loo Lin School of Medicine, NUS\u003cspan style=\"font-size\u0026#58;13px;\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003eChairman, Chapter of Gastroenterologists, College of Physicians, Academy of Medicine 2015-2017\u003c/li\u003e\u003cli\u003eBoard member, Chapter of Gastroenterologists, College of Physicians, Academy of Medicine 2008-present\u003c/li\u003e\u003cli\u003eEditorial Board Member, Endoscopic Ultrasound 2012-present\u003c/li\u003e\u003cli\u003eMember, Asian Telemedicine Working Group\u003c/li\u003e\u003cli\u003eCo-chair, EUS Taskforce Asia-Pacific (EUS-TAP), 2012- present\u003c/li\u003e\u003cli\u003eVisiting Senior Consultant, Khoo Teck Puat Hospital 2010-present\u003c/li\u003e\u003cli\u003eEditorial Board Member, Endoscopy (Thieme)\u0026#160; 2005-2014\u003c/li\u003e\u003cli\u003ePresident, Gastroenterological Society of Singapore 2010-2012\u003c/li\u003e\u003cli\u003eVice-President, Asian Pacific Digestive Week (APDW) 2011, Singapore\u003c/li\u003e\u003cli\u003eCo-director, Live Endoscopy Workshop \u0026amp; Director of Endoscopy Programming, APDW 2011\u003c/li\u003e\u003cli\u003eIndependent Medical Expert, Academy of Medicine/Subordinate Courts 2008\u003c/li\u003e\u003cli\u003eExternal evaluator, Centre for Drug Administration, Health Sciences Authority, Singapore\u003c/li\u003e\u003c/ul\u003e","SHDoctorPublications":null,"SHDoctorPublicationsFullHtml":null,"SHQualification":null,"SHQualificationFullHTML":"\u003cp\u003eMBBS, FRCP (Edin), FAMS, FASGE\u003cbr\u003e\u003c/p\u003e","SHDoctorThumbnailPhotoRender":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg","SHDoctorThumbnailPhoto":{"ImageUrl":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg","Hyperlink":"","OpenHyperlinkInNewWindow":false,"Alignment":"","AlternateText":"","BorderWidth":0,"Height":0,"HorizontalSpacing":0,"VerticalSpacing":0,"Width":0},"SHDoctorThumbnailPhotoUrl":{"Url":"http://authoring.sppub.healthgrp.com.sg/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg","Description":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg"},"SHDoctorPortraitPhoto":{"ImageUrl":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg","Hyperlink":"","OpenHyperlinkInNewWindow":false,"Alignment":"","AlternateText":"","BorderWidth":0,"Height":0,"HorizontalSpacing":0,"VerticalSpacing":0,"Width":0},"SHDoctorPortraitPhotoUrl":{"Url":"http://authoring.sppub.healthgrp.com.sg/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg","Description":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/ChristopherKhor.jpg"},"Email":"","SHDoctorRole":"Doctor;#Researcher;#","SHDoctorSalutation":"Clin Assoc Prof","SHDoctorFirstName":"Khor Jen Lock ","SHDoctorLastName":"Christopher","SHDoctorOtherName":"","SHDoctorHideProfile":false,"SHDoctorPrimarySpecialty":"Gastroenterology ＆ Hepatology","SHDepartmentLink":null,"SHSpecialtyLink":null,"SHSubSpecialtyLink":null,"ListDoctorAcademic":null,"ListDoctorClinical":[{"SHDoctorClinAppPageItemId":"1031","SHDoctorCorporateDesg":"","SHDoctorClinicalAltDesgText":null,"SHDoctorClinicalDesg":"Senior Consultant","SHDoctorClinicalInst":"Singapore General Hospital","SHDoctorClinicalInstLogo":{"Url":"http://authoring.sppub.healthgrp.com.sg/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg","Description":"/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg"},"SHDoctorClinicalInstUrl":{"Url":"http://sgh.com.sg","Description":"http://sgh.com.sg"},"SHDoctorClinicalDept":"Gastroenterology ＆ Hepatology","SHDoctorClinicalDeptLogo":null,"SHDoctorClinicalDeptUrl":null,"SHDoctorClnicApptsFURL":"khor-jen-lock-christopher","SHDoctorClinicalDisplayOrder":1}],"ListDoctorSpecialty":[{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Advanced Endoscopic Imaging","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Diagnostic and Therapeutic Endoscopy","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Gastrointestinal Stenting","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Endoscopic Ultrasound (EUS)","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Endoscopic Retrograde Cholangio-Pancreatography (ERCP)","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Colon Cancer Screening","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD)","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Endoscopic Therapy of early Gastrointestinal Cancer","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Peroral Endoscopic Myotomy (POEM)","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Pancreaticobiliary Disorders","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1031","SHDoctorSpecialityFURL":"khor-jen-lock-christopher"}],"ListDoctorInstitution":[{"SHDepartmentLink":"#Gastroenterology ＆ Hepatology#","SHDepartmentLogoLink":null,"SHDepartmentUrlLink":null,"SHInstitutionLink":"#Singapore General Hospital#","SHInstitutionLogoLink":{"Url":"http://authoring.sppub.healthgrp.com.sg/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg","Description":"/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg"},"SHInstitutionUrlLink":{"Url":"http://sgh.com.sg","Description":"http://sgh.com.sg"},"SHInstLinkDisplayOrder":1000,"SHDoctorInstPageItemId":"1031","SHDoctorInstitutionFURL":"khor-jen-lock-christopher"}],"DoctorProfileInstitutionString":null,"DoctorProfileDepartmentString":null,"DoctorProfileSpecialtyString":null,"DoctorProfileSubSpecialtyString":null,"ListDoctorResearchAppointment":[],"DoctorResearchAppointmentItem":null,"StartDate":"\/Date(-62135596800000)\/","Path":"/profile/khor-jen-lock-christopher","LastUpdatedOn":"\/Date(-62135596800000)\/","LastUpdatedOnString":null,"SHDoctorAcademicProgLogo":null,"SHDoctorAcademicProgURL":null,"SHContentTagType":null,"SingHealthInstitution":"","SingHealthSpecialty":"","TypeOfContent":null,"DoctorFriendlyUrl":"khor-jen-lock-christopher","DoctorSpecialtyFriendlyUrl":null,"SHDoctorResearchEmail":null},{"SHPageId":"1084","BodyPart":"","BodyPartLst":[],"Institution":null,"SHDoctorConditionsTreatments":"#Early Cancer of the Esophagus, Stomach ＆ Colon#, #Colon Cancer Screening#, #Colonic Polyps#, #Complex Colonic Polyps#, #Irritable Bowel Syndrome#, #Constipation#, #Achalasia#, #Viral Hepatitis#, #Cirrhosis#, #GERD#, #Abdominal Pain and Bloating#","SHDoctorConditionsTreatmentsLst":["early cancer of the esophagus, stomach ＆ colon","colon cancer screening","colonic polyps","complex colonic polyps","irritable bowel syndrome","constipation","achalasia","viral hepatitis","cirrhosis","gerd","abdominal pain and bloating"],"SHDoctorAwards":null,"SHDoctorAwardsFullHtml":null,"SHDoctorClinicalDesgDisp":"Senior Consultant","SHDoctorClinicalDesgInstText":"48d80a29-eabe-421e-aa61-202648168f9e|8e9834e6-3ccb-4ee2-bdb9-45837e8602f8;Senior Consultant|8e9834e6-3ccb-4ee2-bdb9-45837e8602f8;","ListSHDoctorClinicalDesgInst":[{"ClinicalDesgName":"Senior Consultant","ClinicalDesgId":"48d80a29-eabe-421e-aa61-202648168f9e","ClinicalDesgInst":"Singapore General Hospital","ClinicalDesgInstId":"8e9834e6-3ccb-4ee2-bdb9-45837e8602f8"}],"ListSHDoctorClinicalDesg":null,"SHDoctorClinicalDesgInstFirst":"Senior Consultant","SHDoctorAltDesgDisp":"","SHDoctorEducation":null,"SHDoctorEducationFullHtml":null,"SHDoctorProfile":null,"SHDoctorProfileFullHtml":null,"SHDoctorResearchInterests":"","SHDoctorResearchInterestsFullHtml":null,"SHDoctorResearchTrials":null,"SHDoctorResearchTrialsFullHtml":null,"SHDoctorProfAppointments":null,"SHDoctorProfAppointmentsFullHtml":"","SHDoctorPublications":null,"SHDoctorPublicationsFullHtml":null,"SHQualification":null,"SHQualificationFullHTML":"\u003cp\u003eMBBS (Spore), MRCP(UK), FAMS\u003c/p\u003e","SHDoctorThumbnailPhotoRender":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg","SHDoctorThumbnailPhoto":{"ImageUrl":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg?Width=199","Hyperlink":"","OpenHyperlinkInNewWindow":false,"Alignment":"","AlternateText":"","BorderWidth":0,"Height":0,"HorizontalSpacing":0,"VerticalSpacing":0,"Width":199},"SHDoctorThumbnailPhotoUrl":{"Url":"http://authoring.sppub.healthgrp.com.sg/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg?Width=199","Description":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg?Width=199"},"SHDoctorPortraitPhoto":{"ImageUrl":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg","Hyperlink":"","OpenHyperlinkInNewWindow":false,"Alignment":"","AlternateText":"","BorderWidth":0,"Height":0,"HorizontalSpacing":0,"VerticalSpacing":0,"Width":0},"SHDoctorPortraitPhotoUrl":{"Url":"http://authoring.sppub.healthgrp.com.sg/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg","Description":"/sites/shcommonassets/Assets/doctors/portrait-photos/Gastro/nvikenesawaran.jpg"},"Email":"","SHDoctorRole":"Doctor;#","SHDoctorSalutation":"Clin Asst Prof","SHDoctorFirstName":"N","SHDoctorLastName":"Vikneswaran ","SHDoctorOtherName":"","SHDoctorHideProfile":false,"SHDoctorPrimarySpecialty":"Gastroenterology ＆ Hepatology","SHDepartmentLink":null,"SHSpecialtyLink":null,"SHSubSpecialtyLink":null,"ListDoctorAcademic":null,"ListDoctorClinical":[{"SHDoctorClinAppPageItemId":"1084","SHDoctorCorporateDesg":"","SHDoctorClinicalAltDesgText":null,"SHDoctorClinicalDesg":"Senior Consultant","SHDoctorClinicalInst":"Singapore General Hospital","SHDoctorClinicalInstLogo":{"Url":"http://authoring.sppub.healthgrp.com.sg/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg","Description":"/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg"},"SHDoctorClinicalInstUrl":{"Url":"http://sgh.com.sg","Description":"http://sgh.com.sg"},"SHDoctorClinicalDept":"Gastroenterology ＆ Hepatology","SHDoctorClinicalDeptLogo":null,"SHDoctorClinicalDeptUrl":null,"SHDoctorClnicApptsFURL":"vikneswaran-n","SHDoctorClinicalDisplayOrder":1000}],"ListDoctorSpecialty":[{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD)","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1084","SHDoctorSpecialityFURL":"vikneswaran-n"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Irritable Bowel Syndrome and Motility Disorders","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1084","SHDoctorSpecialityFURL":"vikneswaran-n"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Early Gastrointestinal Cancers ＆ Dysplasia","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1084","SHDoctorSpecialityFURL":"vikneswaran-n"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Diagnostic and Therapeutic Endoscopy","SHSpecialtyLinkDisplayOrder":1,"SHDoctorSpecPageItemId":"1084","SHDoctorSpecialityFURL":"vikneswaran-n"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Advanced Endoscopic Imaging","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1084","SHDoctorSpecialityFURL":"vikneswaran-n"},{"SHSpecialtyLink":"Gastroenterology ＆ Hepatology","SHSubSpecialtyLink":"Gastroesophageal Reflux Disease (GERD)","SHSpecialtyLinkDisplayOrder":1000,"SHDoctorSpecPageItemId":"1084","SHDoctorSpecialityFURL":"vikneswaran-n"}],"ListDoctorInstitution":[{"SHDepartmentLink":"#Gastroenterology ＆ Hepatology#","SHDepartmentLogoLink":null,"SHDepartmentUrlLink":null,"SHInstitutionLink":"#Singapore General Hospital#","SHInstitutionLogoLink":{"Url":"http://authoring.sppub.healthgrp.com.sg/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg","Description":"/_catalogs/masterpage/HealthXChange/images/logos/SGH-logo.jpg"},"SHInstitutionUrlLink":{"Url":"http://sgh.com.sg","Description":"http://sgh.com.sg"},"SHInstLinkDisplayOrder":1000,"SHDoctorInstPageItemId":"1084","SHDoctorInstitutionFURL":"vikneswaran-n"}],"DoctorProfileInstitutionString":null,"DoctorProfileDepartmentString":null,"DoctorProfileSpecialtyString":null,"DoctorProfileSubSpecialtyString":null,"ListDoctorResearchAppointment":[],"DoctorResearchAppointmentItem":null,"StartDate":"\/Date(-62135596800000)\/","Path":"/profile/vikneswaran-n","LastUpdatedOn":"\/Date(-62135596800000)\/","LastUpdatedOnString":null,"SHDoctorAcademicProgLogo":null,"SHDoctorAcademicProgURL":null,"SHContentTagType":null,"SingHealthInstitution":"","SingHealthSpecialty":"","TypeOfContent":null,"DoctorFriendlyUrl":"vikneswaran-n","DoctorSpecialtyFriendlyUrl":null,"SHDoctorResearchEmail":null}]

Discover articles,videos, and guides afrom Singhealth's resources across the web. These information are collated, making healthy living much easier for everyone.