Achalasia vs Pseudoachalasia: Difference and Comparison

Key Takeaways

  1. Achalasia: Rare esophageal motility disorder, LES fails to relax, difficulty swallowing, treated with medications, dilation, or surgery.
  2. Pseudoachalasia: Mimics achalasia symptoms caused by esophageal tumor (often adenocarcinoma), requires additional tests for diagnosis, treatment focuses on addressing the tumor.
  3. Differentiation: Achalasia is functional, pseudoachalasia is caused by tumor obstruction; important to rule out malignancy for pseudoachalasia diagnosis, treatment approaches vary.

What is Achalasia?

Achalasia is a disease that impacts the esophagus. It is a rare condition. Esophagus is a muscular tube. It is a connection between the mouth and the stomach.


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The LES or lower esophageal sphincter ceases to relax in this disease. It causes food and liquid to build up in the esophagus. It fails to move down into the stomach. As a result, it leads to complications in swallowing. Chest pain and weight loss also become common issues.

The reason for achalasia is unidentified. However, the widespread belief is that the cause is an assortment of genetic and environmental aspects. It is a chronic ailment. It takes several years to develop this condition. Middle-aged people get affected the most by this rare condition.

Various tests, such as a barium swallow or esophageal nanometer, can detect this disorder. Endoscopy also helps to catch additional causes. With antidotes, the prognosis for achalasia is normally good.

Even though it is chronic, one can handle it, and the patient can lead a normal daily life. Nonetheless, one should never keep it untreated. In that case, more complications such as malnutrition, esophageal ulcers, and aspiration pneumonia will arise.

What is Pseudoachalasia?

When it comes to the symptoms of pseudoachalasia, one will notice the similarities between achalasia and pseudoachalasia. Underlying diseases are responsible for this condition. It is a secondary motility disorder.

External factors, for example, a tumor or another disease of the esophagus, is the reason for this disease. Imaging studies like endoscopy, biopsy, and barium swallow will help doctors to identify the hidden cause of the discomfort. Depending on the cause, the treatment process gets fixed.

Treatment of pseudoachalasia is much more tricky than achalasia. The doctor will select chemotherapy to cure the ailment if a tumor causes the disease. This will revive the functionality of the esophageal. Early diagnosis and proper antidote are crucial for the best result.

Difference Between Achalasia and Pseudoachalasia

  1. Achalasia is a primary state, whereas pseudoachalasia is a secondary state.
  2. The cause of achalasia is unknown, but pseudoachalasia occurs due to other underlying conditions.
  3. Both achalasia and pseudoachalasia are rare, but compared to achalasia, pseudoachalasia is more common.
  4. The prognosis of achalasia is generally good when under treatment, but the prognosis of pseudoachalasia varies based on the underlying condition.
  5. Symptoms of achalasia comprise chest pain, regurgitation of food and liquid, heartburn, and weight loss. Pseudoachalasia shares the same symptoms, and in addition to these, one can also experience reflux and other signs of gastroesophageal reflux disease.

Comparison Between Achalasia and Pseudoachalasia

Parameter of ComparisonAchalasiaPseudoachalasia
DescriptionIt is a primary motility disorder of the esophagus.It is known as the secondary to a tumor or other disease.
Cause of effectIts reason is unknown.           It is caused by malignancy or other underlying conditions.
Area of effectIt impacts the lower esophageal sphincter.It might impact the entire esophagus.
The number of casesThis disease is very rare.It is a rare disease too, but compared to achalasia, it is more common.
AgeIn most cases, middle-aged people can get affected by this disease.People of any age can suffer from this disorder. However, older adults are the most affected.
TreatmentMedication, balloon dilation, or surgery are effective remedies for this disease.Fundamentally the treatment depends on the cause of the disorder, but surgery, radiation therapy, and chemotherapy are helpful ways to heal.
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