Vigorous achalasia: Zebra amongst horses

Area of Science:

• Gastroenterology
• Esophageal Motility Disorders

Background:

• Vigorous achalasia is a rare esophageal disorder.
• It shares clinical and radiological features with classic achalasia and diffuse esophageal spasm.
• Misdiagnosis as diffuse esophageal spasm is common.

Purpose of the Study:

• To report a case of vigorous achalasia.
• To highlight the diagnostic challenges and characteristics of this rare variant.

Main Methods:

• Case report of a 60-year-old gentleman with a 10-year history of dysphagia, regurgitation, and chest pain.
• Diagnostic workup included endoscopy and barium swallow.

Main Results:

• The patient's symptoms persisted despite proton pump inhibitor treatment.
• Endoscopy and barium swallow confirmed the diagnosis of vigorous achalasia.
• Vigorous achalasia was confirmed as a rare variant of achalasia.

Conclusions:

• Vigorous achalasia requires careful differentiation from diffuse esophageal spasm.
• Accurate diagnosis is crucial for appropriate patient management.