Progressive swallowing difficulties, more so to solids.
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Dilated, adynamic esophagus with a fluid level and failure to empty.
Bird beak appearance at the GEJ. Trace of barium into the stomach.
The appearances of achalasia are almost pathognomonic on barium swallow. These include:
- a gas-filled dilated esophagus on control film
- a distended esophagus with an air-fluid level
- an adynamic esophagus
- a distal acute taper of the esophagus with a bird-beak appearance.