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