gastrointestinal disorders
Achalasia
Symptoms and Signs of Achalasia
Achalasia occurs at any age but usually begins between ages 20 and 60. Onset is insidious, and progression is gradual over months or years. Dysphagia for both solids and liquids is the major symptom. Nocturnal regurgitation of undigested food occurs in about 33% of patients and may cause cough and pulmonary aspiration. Chest pain is less common but may occur on swallowing or spontaneously. Mild to moderate weight loss occurs; when weight loss is pronounced, particularly in older patients whose symptoms of dysphagia developed rapidly, pseudoachalasia secondary to a tumor of the gastroesophageal junction should be considered. 