Chest pain
Regurgitation
Heartburn
Esophageal manometry (the criterion standard): Incomplete LES relaxation in response to swallowing, high resting LES pressure, absent esophageal peristalsis
Prolonged esophageal pH monitoring to rule out gastroesophageal reflux disease and determine if abnormal reflux is being caused by treatment
Barium swallow: Bird’s beak appearance, esophageal dilatation
Dysphagia (most common)
Weight loss
Concomitant endoscopic ultrasonography if a tumor is suspected
Esophagogastroduodenoscopy to rule out cancer of the GEJ or fundus
