American Board of Internal Medicine (ABIM) Certification Practice Exam 2025 - Free ABIM Practice Questions and Study Guide

Achalasia is a disorder of the esophagus that affects its ability to move food toward the stomach. The hallmark symptom associated with this condition is chest pain when swallowing, known as dysphagia. This occurs because the lower esophageal sphincter fails to relax appropriately, causing food to accumulate in the esophagus and leading to discomfort or pain during the swallowing process.

While other symptoms may occur in achalasia, such as regurgitation or weight loss, chest pain during swallowing is most indicative of the motility dysfunction that characterizes this condition. The challenges with food passage can lead to this sharp, often distressing sensation, making it a significant symptom for diagnosis.

The other options, while they can represent symptoms of different gastrointestinal conditions, do not specifically relate to achalasia. Severe heartburn is more commonly associated with gastroesophageal reflux disease (GERD), frequent diarrhea is typically linked with other gastrointestinal issues, and severe abdominal bloating can be related to various functional or obstructive disorders, but not specifically to achalasia. This makes the chest pain upon swallowing distinctly significant in the context of identifying achalasia.