It is important to rule out other diagnosis like achalasia and stricture secondary to gastroesophageal reflux

Esophageal pH monitoring is valuable in this regard.

Investigations such as pH monitoring, manometry, and endoscopic biopsy are performed to rule out other conditions mimicking CES such as acquired esophageal stenosis and achalasia. It is not uncommon for achalasia to be confused with CES.

Radiologically, it is difficult to differentiate between the three types but membranous (web) obstruction is more localized affecting a much shorter segment, but in the presence of severe proximal dilatation this may be difficult to demonstrate.