We have seen patients with symtpoms that mimic ALS and achalasia but not as the primary manifestation. Problems with swallowing and reflux are common with bulbar ALS, however, the symptoms of ALS are so prominent that diagnosis is not difficult. Usually the life span with someone diagnosed with ALS of the bulbar type is about a year, so with not other symptoms you do not have ALS. In addition, classic achalasia with pipe-like esophagus is usually not seen in ALS. Some patients with MS have difficulty swallowing, but again not the classic picture of achalasia. I would not think you have MS either. Furthermore, this would not be a classical presentation of MS.
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