Definition

Achalasia is a problem moving food through the muscular tube (esophagus) that connects the mouth to the stomach. It is rare.

Causes

It is caused by a breakdown in the nerve cells in the esophagus. The reason why this happens is not known.

Risk Factors

There are no known risk factors for this problem.

Symptoms

The most common symptoms is difficulty swallowing solids and liquids. It may cause swallowed foods to be brought back up into the mouth.

Other problems may be:

• Heartburn
• Vomiting
• Chest pain
• Pain the upper part of the abdomen
• Pain when swallowing
• Coughing
• Hoarse or sore throat
• Losing weight without trying

Heartburn / Reflux Disease

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Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

These tests may be done to view the esophagus:

• Upper gastrointestinal (GI) endoscopy—uses a flexible tube and camera
• Upper GI series—uses contrast material to take detailed X-rays

Manometry may be done to confirm the diagnosis. It uses a tube to test the pressure in the esophagus and the stomach when swallowing.

Treatment

There is no cure. The goal of treatment is to allow food and liquids to pass to the stomach. Choices are:

• Surgery to cut the muscles in the esophagus to allow food to pass
• Medicines, such as:
  • Muscle relaxants
  • Calcium channel blockers to ease pressure in the esophagus
• Botulinum toxin injections into the muscles to relax them
• Pneumatic dilation to stretch the muscles in the esophagus

Prevention

There are no current guidelines to prevent this health problem.