What is Achalasia?

Achalasia is an esophageal disease that inhibits normal esophageal emptying. In patients with Achalasia, specific esophageal nerve fibers are damaged. The esophagus loses its capacity to push, and the valve at the lower end of the esophagus (also known as the lower esophageal sphincter) does not relax adequately, leading to difficulties swallowing and a number of accompanying symptoms. Achalasia is in many respects the opposite of GERD, but often patients have similar “heartburn” symptoms so are treated for GERD for many years before the correct diagnosis is made. Achalasia patients have an abnormally tight lower esophageal sphincter, whereas GERD patients have a weaker lower esophageal sphincter. Both illnesses can have a significant influence on a patient’s quality of life and, if left untreated, can result in more serious health problems.

Achalasia, like GERD, can occur at any age, but is more prevalent in middle-aged and older people. It affects men and women equally, and no specific causes have been identified.


Symptoms of Achalasia

Achalasia patients may experience any number of symptoms, however the following are the most common:

  • Dysphagia or food or liquid just sitting in the chest region
  • Chest Pain, especially after eating a few bites
  • Regurgitation of liquids and undigested solid food
  • Heartburn
  • Weight Loss
  • Pneumonia / Aspiration
  • Vomiting

How to Diagnose Achalasia

There are two primary diagnostic tests used to identify Achalasia. These are essential for determining which subtype of achalasia a patient has, which has a significant impact on the treatment regimen.

  • Timed Barium Esophagram: a specialized xray where liquid barium is administered in a specific sequence and xrays taken at specific times after swallowing to assess if there is any delay in passage
  • Esophageal Manometry or Motility Testing: the “gold standard” for diagnosing and further classifying achalasia into subtypes. Specially trained GI nurses insert a small tube containing a pressure gauge system into the esophagus and stomach. The patient swallows an electrolyte solution which quantifies the strength and effectiveness of the esophagus and lower esophageal sphincter.

Treatment of Achalasia

There are multiple therapeutic options available to minimize the symptoms of Achalasia, but Achalasia is a lifelong illness for which there is presently no “cure”. No intervention will be able to restore the motility of the esophagus to its normal state. All interventions are directed at decreasing the barrier caused by the tight lower esophageal sphincter in order to allow easier passage of liquids and solids into the stomach.

achalasia treatment

get help today

Contact Us for an Appointment

get help today

Contact Us
for an Appointment