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Achalasia

(Esophageal Achalasia)

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

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:

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.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Health Canada
https://www.canada.ca

REFERENCES:

Achalasia. EBSCO Plus DynaMed website. Available at: https://www.dynamed.com/condition/achalasia. Accessed October 29, 2020.

Achalasia and esophageal motility disorders. The Society of Thoracic Surgeons website. Available at: https://ctsurgerypatients.org/lung-esophageal-and-other-chest-diseases/achalasia-and-esophageal-motility-disorders. Accessed October 29, 2020.

Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015 May 12;313(18):1841-1852.

Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 4/28/2021