Which statement about achalasia is accurate?

Which statement about achalasia is accurate?

• A. The LES opens during swallowing
• B. The LES fails to open during swallowing
• C. Peristalsis is enhanced
• D. It causes rapid gastric emptying

Answer: (B)

In achalasia, the key problem is that the lower esophageal sphincter (LES) does not relax properly when you swallow, so food can’t pass from the esophagus into the stomach. This leads to symptoms like difficulty swallowing both solids and liquids, regurgitation, and progressive dilation of the esophagus because the passage is blocked at the junction. The esophagus often has little or no coordinated peristaltic activity, so it can’t push food down effectively. Diagnostic testing typically shows incomplete LES relaxation with swallowing and absent or markedly reduced peristalsis. So the statement that the LES fails to open during swallowing is accurate because the essential defect in achalasia is failure of LES relaxation, not opening, which blocks esophageal emptying. The other ideas don’t fit: the LES opening during swallowing would imply normal relaxation, which is not the case; peristalsis is not enhanced—in fact, it’s diminished or absent; and rapid gastric emptying is not a feature—the problem is delayed passage of food into the stomach, not accelerated gastric emptying.

In achalasia, the key problem is that the lower esophageal sphincter (LES) does not relax properly when you swallow, so food can’t pass from the esophagus into the stomach. This leads to symptoms like difficulty swallowing both solids and liquids, regurgitation, and progressive dilation of the esophagus because the passage is blocked at the junction. The esophagus often has little or no coordinated peristaltic activity, so it can’t push food down effectively. Diagnostic testing typically shows incomplete LES relaxation with swallowing and absent or markedly reduced peristalsis.

So the statement that the LES fails to open during swallowing is accurate because the essential defect in achalasia is failure of LES relaxation, not opening, which blocks esophageal emptying. The other ideas don’t fit: the LES opening during swallowing would imply normal relaxation, which is not the case; peristalsis is not enhanced—in fact, it’s diminished or absent; and rapid gastric emptying is not a feature—the problem is delayed passage of food into the stomach, not accelerated gastric emptying.