A 70 year old patient comes with symptoms of achalasia from 3 months. Radiologic features and manometric studies show the typical features of achalasia. What is the next step: (A) CT scan, (B) Heller's myotomy, (C) Nissens fundoplication, (D) 24 hour ph monitoring
Answer is A. This might be the case of pseudo achalasia. It is suspected when

Patient older than 60
Dysphagia less than 6 months
Excessive weight loss

Sometimes infiltrating tumor at gastroesophageal junction will mimic achalasia symptoms and manometric studies. To rule out tumor CT scan must be done