Achalasia Classification Types - Barium Contrast Esophagram: 1) Spindle type (classic) 2) Flask type 3) Sigmoid type Response to treatment: 2>1>3 Sigmoid shape is suggestive of end stage achalasia and myotomy has much lower efficacy at that stage. Essentially it is no longer an issue of just hypertonic LES since the esophagus "acts like a bag" now. Hence, esophagectomy might need to be considered. #Achalasia #Classification #Types #radiology #gastroenterology #clinical #barium #contrast #Esophagram