The most common clinical symptom for achalasia is dysphagia. Patients typically present with solid 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 and aspirations). Symptoms worsen gradually with disease duration. The esophagus slowly dilates and looses its function in food transport. The single objective measure in assessing esophageal dysfunction is barium esophagogram. Ninety percent of patients with achalasia have typical radiographic finding (the so-called “bird beak”) created by failure of the lower esophageal sphincter to relax In the early phase of the disease, endoscopic and radiologic findings can be completely normal. Finally, the diagnosis is confirmed or ruled out by manometry of the upper digestive tract. Absence of effective peristalsis of the esophageal body and failure of the lower esophageal sphincter (LES) to completely relax upon swallowing are the most characteristic.