What causes achalasia?
The esophagus is a tube that carries food from the mouth to the stomach. The esophagus does not function correctly in people with achalasia. In some cases, the lower part of the esophagus is ineffective in moving food into the stomach. In other cases, a circular band of muscle that separates the stomach from the esophagus, called the lower esophageal sphincter (LES), does not relax properly in response to swallowing. When this band of muscle (LES) does not relax, it creates a barrier to food entering the stomach. Damage to the LES can cause large volumes of food and saliva to accumulate in the esophagus.
What are the symptoms of achalasia?
The major symptom of achalasia is difficulty swallowing liquids or solids. Other symptoms include chest pain, heartburn, and a sensation of fullness or a lump in the throat, hiccups or weight loss.
How is achalasia diagnosed?
Your doctor will review your symptoms and may order additional tests such as a chest X-ray or endoscopy. Your doctor may also order a barium swallow test, which involves swallowing a chalky mixture while a radiologist watches the swallow with an X-ray. Esophageal manometry is also frequently used to diagnosis achalasia. Manometry involves placement of a thin tube in the esophagus to measure the pressure throughout the esophagus and LES.
How is achalasia treated?
Many treatment options are available for the symptoms of achalasia; however none can reverse or correct the underlying problem. 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.
Seeking 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.