Endoscopy first: Upper GI endoscopy to exclude cancer at the cardia (pseudo-achalasia), then barium swallow and high-resolution manometry (ACG 2020)
Definitive treatment: Pneumatic dilatation, POEM or laparoscopic Heller myotomy with fundoplication — by gastroenterology or surgery (ACG 2020; ESNM 2020)
Investigations
First visit
Upper GI endoscopy — Exclude cancer at the gastro-oesophageal junction.
Barium swallow (timed) — Bird-beak narrowing and dilated oesophagus.
Only if indicated
High-resolution oesophageal manometry — Confirms and types achalasia before treatment.
CT chest/abdomen — Age over 55, rapid onset or weight loss (pseudo-achalasia).
Locked
The adult dose for each drug
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.