The most common clinical symptom for achalasia is dysphagia. Patients typically present with food dysphagia and varied degrees of liquid dysphagia, in particular cold liquids, occasional regurgitations of undigested food, and heartburn. Clinical symptoms may also suggest respiratory complications (nocturnal cough The most common clinical symptom for achalasia is dysphagia.
Balloon dilatation for achalasia can be safely undertaken as an outpatient procedure in most patients. It requires a patient properly consented to the procedural risks of bleeding, perforation, and aspiration events. It also requires that the patient understands there is a significant chance that the procedure may need to be repeated in future should the initial therapeutic result fail to be satisfactory and/or durable.
The patient must be fasted, and in the setting of achalasia this often requires a more extended period without solid food to avoid performing a procedure on a patient with a very large volume of esophageal food debris, which is tedious to clear and increases the risk of peri-procedural aspiration.