Understanding Achalasia: Causes, Symptoms, and Management

What is it?

Patients with achalasia find it difficult to swallow liquids or food. In achalasia, the lower esophageal sphincter (LES), which closes the esophagus from the stomach, is damaged, and opens up during swallowing.Thus, food can move backwards into the mouth. Etiology is not fully understood but it can be related to damage to the esophageal innervation or to the LES. Achalasia can be secondary to autoimmune conditions or hereditary.

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Additional names

This group contains additional names:
- Achalasia of esophagus
- Acquired achalasia
- Megaesophagus due to Chagas disease

Signs & symptoms

Symptoms of achalasia may include dysphagia (swallowing difficulties), heartburn, belching, recurrent chest pain, night cough, pneumonia, weight loss and vomiting.

Diagnosis

If the patient's symptoms or complaints fit to achalasia, an esophageal manometry can be performed. A manometry test measures the frequency, force and coordination of muscle contraction in the esophagus and LES function. It is done by a tube placed in the esophagus. Other tests may include esophagram which is an upper digestive tract X RAY performed while the patient swalls liquid or food. marked with barium.A gastroscopy may also be performed to rule out esophageal blockage or in order to take a biopsy.

Treatment

Treatment for achalasia includes non surgical options such as pneumatic dilation which is a balloon that is inserted by an endoscope and located in the LES, enlarging its opening. This treatment sometimes has to be repeated. Injections of botulinum toxin, a muscle relaxant, are also used to treat this condition. Other medications used are nitroglycerin and nifedipine, but they have many side effects. Surgery can also be suggested. Heller myotomy is when a part of the LES is being cut. In order to avoid gastroesophageal reflux disease (GERD), this procedure usually also involves a fundoplication. Fundoplication is a creation of an anti-reflux valve from the top of the stomach, by wrapping it around the lower esophagus. These are usually done with minimally invasive (laparoscopic) procedures.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital