What are the mimickers of achalasia (esophageal motility disorder)?

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Last updated: May 15, 2025View editorial policy

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Differential Diagnosis for Mimickers of Achalasia

  • Single most likely diagnosis
    • Esophageal stricture: This is a common condition that can mimic achalasia by causing dysphagia to solids. The stricture can be due to various causes such as gastroesophageal reflux disease (GERD), esophagitis, or caustic ingestion.
  • Other Likely diagnoses
    • Diffuse esophageal spasm: This condition is characterized by abnormal esophageal contractions that can cause chest pain and dysphagia, similar to achalasia.
    • Esophagitis: Inflammation of the esophagus can cause symptoms similar to achalasia, such as dysphagia and odynophagia.
    • Scleroderma: This autoimmune disorder can cause esophageal dysmotility, leading to symptoms similar to achalasia.
  • Do Not Miss diagnoses
    • Esophageal cancer: Although less common, esophageal cancer can present with symptoms similar to achalasia, such as dysphagia and weight loss. Missing this diagnosis can be fatal.
    • Chagas disease: This parasitic infection can cause achalasia-like symptoms, and missing the diagnosis can lead to serious cardiac and gastrointestinal complications.
  • Rare diagnoses
    • Eosinophilic esophagitis: This condition is characterized by an eosinophilic infiltration of the esophagus, leading to symptoms such as dysphagia and food impaction.
    • Inlet patch: This is a rare condition where a patch of gastric mucosa is present in the upper esophagus, causing symptoms similar to achalasia.
    • Esophageal leiomyoma: This is a rare benign tumor of the esophagus that can cause symptoms similar to achalasia, such as dysphagia and chest pain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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