A contrast study, where a radio-opaque dye is swallowed and then X-rays taken can demonstrate the classical features of achalasia including a widened, weak oesophagus which ends in abrupt narrowing at the junction with the stomach (“birds beak”) and sometimes a very small band of contrast dye going through the LOS (“rats-tail”).
Following my Heller Cardiomyotomy I am pleased to tell you that at this moment it would appear to be 100% successful. It is no exaggeration to say it has transformed my life.
Oesophageal physiology is also used and this gives a very accurate measure on the severity of the achalasia (Chicago classification 1-3) and provides information on the extent of weakness in the oesophagus and raised pressure in the LOS as well as how these function during swallowing.
These investigations are very useful in deciding what the best management and treatment options might be.