Learn About Achalasia

What is the definition of 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.

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What are the alternative names for Achalasia?

Esophageal achalasia; Swallowing problems for liquids and solids; Cardiospasm - lower esophageal sphincter spasm

What are the causes of Achalasia?

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.

What are the symptoms of Achalasia?

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
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What are the current treatments for Achalasia?

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 drugs can be used to relax the lower esophagus sphincter. But there is rarely a long-term solution to treat achalasia.
  • Surgery (called a myotomy) -- In this procedure, the lower sphincter muscle is cut. This procedure is usually performed using a laparoscope.
  • 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.

Who are the top Achalasia Local Doctors?
Elite
Highly rated in
14
conditions
Gastroenterology

Northwestern Medicine

Northwestern Medicine Digestive Health Center

259 E Erie St 
Chicago, IL 60611

John Pandolfino is a Gastroenterologist in Chicago, Illinois. Dr. Pandolfino has been practicing medicine for over 29 years and is rated as an Elite doctor by MediFind in the treatment of Achalasia. He is also highly rated in 14 other conditions, according to our data. His top areas of expertise are Achalasia, Gastroesophageal Reflux Disease, Swallowing Difficulty, and Hiatal Hernia. He is licensed to treat patients in Illinois. Dr. Pandolfino is currently accepting new patients.

Elite
Highly rated in
12
conditions
Gastroenterology

Northwestern Medicine

Northwestern Medicine Digestive Health Center

259 E Erie St 
Chicago, IL 60611

Dustin Carlson is a Gastroenterologist in Chicago, Illinois. Dr. Carlson has been practicing medicine for over 13 years and is rated as an Elite doctor by MediFind in the treatment of Achalasia. He is also highly rated in 12 other conditions, according to our data. His top areas of expertise are Achalasia, Swallowing Difficulty, Esophagitis, and Gastroesophageal Reflux Disease. He is licensed to treat patients in Illinois. Dr. Carlson is currently accepting new patients.

 
 
 
 
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Elite
Highly rated in
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General Surgery

Northwestern Medicine

Northwestern Medicine Digestive Health Center

259 E Erie St 
Chicago, IL 60611

Eric Hungness is a General Surgeon in Chicago, Illinois. Dr. Hungness has been practicing medicine for over 25 years and is rated as an Elite doctor by MediFind in the treatment of Achalasia. He is also highly rated in 10 other conditions, according to our data. His top areas of expertise are Achalasia, Hiatal Hernia, Congenital Diaphragmatic Hernia, and Choledocholithiasis. He is licensed to treat patients in Illinois. Dr. Hungness is currently accepting new patients.

What is the outlook (prognosis) for Achalasia?

The outcomes of surgery and non-surgical treatments are similar. More than one treatment is sometimes necessary.

What are the possible complications of Achalasia?

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
When should I contact a medical professional for Achalasia?

Contact your provider if:

  • You have trouble swallowing or painful swallowing
  • Your symptoms continue, even with treatment for achalasia
How do I prevent Achalasia?

Many of the causes of achalasia cannot be prevented. However, treatment may help to prevent complications.

Digestive system
Upper gastrointestinal system
Achalasia - series
What are the latest Achalasia Clinical Trials?
Assessment of the Neuro-glio-epithelial Unit (NGEU) in Biopsies Taken During Peroral Endoscopic Myotomy (POEM) for Achalasia: a Feasibility and Safety Study.
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Health-Related Quality of Life After Peroral Endoscopic Myotomy for Patients With Achalasia
What are the Latest Advances for Achalasia?
Achalasia - position of surgery in current management.
Comparison of fully coated anti-reflux metal stenting and per-oral endoscopic myotomy in patients with achalasia: a propensity score-matched retrospective study.
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Features and results of minimally invasive treatment of recurrent achalasia.
Who are the sources who wrote this article ?

Published Date: October 25, 2021
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.

Hamer PW, Lamb PJ. The management of achalasia and other motility disorders of the oesophagus. In: Griffin SM, Lamb PJ, eds. Oesophagogastric Surgery: A Companion to Specialist Surgical Practice. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 16.

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.