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How can a barium swallow distinguish achalasia from scleroderma?
- If the condition results in dysmotility that is at least moderate in severity, barium swallow abnormalities are usually different in these two conditions.
Achalasia versus Scleroderma
| Esophageal Dilatation | Peristalsis in Pure Smooth Muscle Part of Esophagus | Esophagogastric Junction | |
|---|---|---|---|
| Achalasia | May be marked | Absent | Beak: smooth, concentric, tapered, flexible No hiatus hernia |
| Scleroderma | Minimal or moderate | Weak, incomplete, or absent | Stricture from esophagitis: cylindrical, rigid, sometimes irregular or ulcerated Often a sliding hiatus hernia |
