Achalasia Overview
Learn About Achalasia
The tube that carries food from the mouth to the stomach is the esophagus or food pipe. Achalasia makes it harder for the esophagus to move food into the stomach.
Esophageal achalasia; Swallowing problems for liquids and solids; Cardiospasm - lower esophageal sphincter spasm
There is a muscular ring at the point where the esophagus and stomach meet. It is called the lower esophageal sphincter (LES). Normally, this muscle relaxes when you swallow to allow food to pass into the stomach. In people with achalasia, it does not relax as it should. In addition, the normal muscle activity of the esophagus (peristalsis) is reduced or absent.
This problem is caused by damage to the nerves of the esophagus.
Other problems can cause similar symptoms, such as cancer of the esophagus or upper stomach, and a parasite infection that causes Chagas disease, which is more common in Mexico and Central and South America.
Achalasia is rare. It may occur at any age, but is most common in people ages 25 to 60. In some people, the problem may be inherited.
Symptoms include:
- Backflow (regurgitation) of food
- Chest pain, which may increase after eating, or may be felt as pain in the back, neck, and arms
- Cough
- Difficulty swallowing liquids and solids
- Heartburn
- Unintentional weight loss
The goal of treatment is to reduce the pressure at the sphincter muscle and allow food and liquids to pass easily into the stomach. Therapy may involve:
- Injection with botulinum toxin (Botox) -- This may help relax the sphincter muscles. However, the benefit wears off within a few weeks or months.
- Medicines, such as long-acting nitrates or calcium channel blockers -- These medicines can be used to relax the lower esophagus sphincter. But there is rarely a long-term solution with medicines to treat achalasia.
- Surgery (called a myotomy) -- In this procedure, the lower sphincter muscle is cut. This procedure is usually performed using a laparoscope. It can now sometimes be performed during EGD instead of traditional surgery.
- Widening (dilation) of the esophagus -- This is done during EGD by stretching the LES with a balloon dilator.
Your health care provider can help you decide which treatment is best for you.
Inova Health Care Services
Kei Suzuki is a Thoracic Surgeon and a General Surgeon in Fairfax, Virginia. Dr. Suzuki and is rated as an Experienced provider by MediFind in the treatment of Achalasia. His top areas of expertise are Lung Nodules, Fibrosing Mediastinitis, Lymphofollicular Hyperplasia, Advanced Bronchoscopy, and Endoscopy. Dr. Suzuki is currently accepting new patients.
MedStar Washington Hospital Center
MedStar Center is a Thoracic Surgeon in Washington, District of Columbia. Dr. Center and is rated as an Experienced provider by MediFind in the treatment of Achalasia. His top areas of expertise are Fibrosing Mediastinitis, Lung Nodules, Lung Cancer, Endoscopy, and Gastrostomy.
Inova Health Care Services
Firas Al-Kawas is a Gastroenterologist in Fairfax, Virginia. Dr. Al-Kawas and is rated as an Advanced provider by MediFind in the treatment of Achalasia. His top areas of expertise are Bile Duct Obstruction, Familial Adenomatous Polyposis, Cholestasis, Endoscopy, and Colonoscopy. Dr. Al-Kawas is currently accepting new patients.
The outcomes of surgery and non-surgical treatments are similar. However, depending on the type of achalasia you have, your provider may recommend a particular procedure. More than one treatment is sometimes necessary.
Complications may include:
- Backflow (regurgitation) of acid or food from the stomach into the esophagus (reflux)
- Breathing food contents into the lungs (aspiration), which can cause pneumonia
- Tearing (perforation) of the esophagus
Contact your provider if:
- You have trouble swallowing or painful swallowing
- Your symptoms continue, even with treatment for achalasia
Many of the causes of achalasia cannot be prevented. However, treatment may help to prevent complications.
Summary: This is prospective data recording study. All patients will receive standard medical care and no experimental interventions will be performed.
Summary: The purpose of this study is to identify markers in the blood and tissue that could indicate risk factors for the development and progression of esophagus cancer. This research aims to collect medical history, blood, and tissue samples from patients who present with an esophageal disorder. Identifying genetic and behavioral risk factors involved in the development of esophageal cancer might allow ...
Published Date: December 31, 2023
Published By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 124.
Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 44.