What is pseudoachalasia? How is it diagnosed?
Pseudoachalasia, or secondary achalasia, is an esophageal motility disorder caused by a distal esophageal obstruction from an infiltrating tumor that may directly intrinsically or extrinsically compress the esophagus Patients exhibit symptoms typical of achalasia, including dysphagia, regurgitation, chest pain, and weight loss. Conventional manometry, endoscopy, and radiologic examination cannot distinguish pseudoachalasia from achalasia. Endoscopy helps rule out the possibility of pseudoachalasia but cannot diagnose a mural or extramural tumor. When this is suspected, based on a history of substantial weight loss (more than 20 lb in 6 months), endoscopic ultrasonography or computed tomography is recommended. The main distinguishing feature is the complete reversal of pathologic motor phenomena following successful therapy of the underlying disorder.