Barium swallow: Bird’s beak appearance, esophageal dilatation
Esophageal manometry (the criterion standard): Incomplete LES relaxation in response to swallowing, high resting LES pressure, absent esophageal peristalsis
Esophagogastroduodenoscopy to rule out cancer of the GEJ or fundus
Heartburn
Regurgitation
Dysphagia (most common)
Chest pain
Concomitant endoscopic ultrasonography if a tumor is suspected
Weight loss
Prolonged esophageal pH monitoring to rule out gastroesophageal reflux disease and determine if abnormal reflux is being caused by treatment
