There is a diagnostic method of bougienage with a bag filled with mercury, which passes into the stomach in the absence of stricture under the influence of its own weight.
Differential diagnosis is carried out with tumors of the esophagus, esophagitis, cicatricial narrowing, diverticula and ulcers of the esophagus, hiatal hernias, esophagospasm and coronary heart disease. The finding of diverticula of the esophagus does not exclude achalasia of the cardia. Possible combination of achalasia cardia with esophagitis.
In the differential diagnosis of achalasia cardia and coronary heart disease, the age of patients and the effect of taking nitrates are not always significant. Dysphagia, regurgitation, pain relief after 1-2 sips of water and the absence of autonomic disorders (changes in blood pressure, perspiration, etc.) should be taken into account, even with prolonged chest pain in the case of achalasia of the cardia. Significantly facilitate the diagnosis of ECG and the study of enzyme activity.
With spasmodic retrosternal pain, it is recommended to drink water in sips, nitrates and antispasmodics. In mild cases of achalasia of the cardia, conservative treatment is acceptable, including fractional sparing nutrition. Patients are advised to drink some warm or carbonated water after meals.