What is achalasia?
Achalasia is a disorder characterized by difficulty swallowing. It is a rare condition that affects only 1 in every 100,000 people.
What causes achalasia?
The esophagus is a muscular tube that carries food from the mouth to the stomach. The esophagus does not function correctly in people with achalasia. In Achalasia patients, there is poor muscle function in the esophagus and a failure of the lower esophageal sphincter (LES) to relax. This creates a barrier to food entering the stomach which causes trouble swallowing.
What are the symptoms of achalasia?
The major symptom of achalasia is difficulty swallowing liquids or solids. Other symptoms include chest pain, heartburn, a sensation of fullness or a lump in the throat, hiccups or unintentional weight loss.
How is achalasia diagnosed?
Tests that are used to diagnose achalasia may include upper endoscopy (EGD), barium esophagram and high resolution esophageal manometry.
During an upper endoscopy, a flexible viewing tube is inserted through the mouth into the esophagus allowing for direct visualization of the inner lining of the esophagus and the stomach.
Barium swallow test, or esophagram, involves swallowing a chalky mixture while a radiologist watches the swallow with an X-ray.
Esophageal manometry involves placement of a thin tube in the esophagus to measure the pressure throughout the esophagus and LES.
How is achalasia treated?
Several treatment options are available for the symptoms of achalasia. Your doctor may recommend muscle relaxing drug therapy to help the LES relax and decrease symptoms. Botox injections at the LES may also work to reduce LES pressure. Your doctor may also recommend stretching the esophagus with a balloon during endoscopy or under X-ray. Surgery may also be necessary to directly cut the muscle fibers of the LES.
When to seek medical advice
Many people delay seeking medical attention until symptoms are advanced. Contact your health care providers if you are noticing difficulty swallowing liquids or solids, or if you are experiencing chest pain, frequent heartburn or unexplained weight loss.