Achalasia is a rare issue where food has trouble moving through the esophagus, the muscular tube that connects the mouth to the stomach.
Achalasia is caused by a breakdown in the nerve cells in the esophagus. The reason why this happens is not known.
There are no known risk factors for this problem.
The most common symptom is having trouble swallowing solids and liquids. It may cause swallowed foods to be brought back up into the mouth.
A person with achalasia may also have:
- Chest pain
- Pain in the upper part of the abdomen
- Pain when swallowing
- Hoarse or sore throat
- Losing weight without trying
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The doctor will ask about symptoms and health history. A physical exam will be done.
These tests may be done to look at the esophagus:
- Upper gastrointestinal (GI) endoscopy—uses a flexible tube and camera
- Upper GI series—uses contrast material to take detailed X-rays
Manometry may be done to confirm a person has achalasia. It uses a tube to test the pressure in the esophagus and the stomach when swallowing.
The goal of treatment is to allow food and liquids to pass to the stomach. Ways to do this are:
- Surgery to cut the muscles in the esophagus to let food pass
- Medicines such as:
- Muscle relaxants
- Calcium channel blockers to ease pressure in the esophagus
- Botulinum toxin injections into the muscles to relax them
- Pneumatic dilation to stretch the muscles in the esophagus
There is no cure for achalasia.
Achalasia cannot be prevented.
- Achalasia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/achalasia.
- Achalasia and esophageal motility disorders. The Society of Thoracic Surgeons website. Available at: https://ctsurgerypatients.org/lung-esophageal-and-other-chest-diseases/achalasia-and-esophageal-motility-disorders.
- Pandolfino, J.E. and Gawron, A.J. Achalasia: a systematic review. JAMA, 2015; 313 (18): 1841-1852.
- James P. Cornell, MD
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