Achalasia | Digestive Health Program | Loyola Medicine

Achalasia

Overview and Facts about Achalasia

Achalasia is a type of digestive health disorder in which it becomes hard to swallow food and liquids. In this condition, nerves in the esophagus become damaged, preventing relaxation of the lower esophageal sphincter, which separates the esophagus from the stomach. Contractions of the esophagus, which usually push food down into the stomach, no longer occur.

Signs and Symptoms of Achalasia

If you have achalasia, your main problem is difficulty swallowing food. It might feel as if you have food stuck in your throat. Other symptoms you might notice include:

  • Chest pain
  • Discomfort after eating
  • Heartburn
  • Increased occurrences of inhaling or choking on food
  • Regurgitation of food
  • Unexpected weight loss

Causes and Risk Factors of Achalasia

Unfortunately, doctors don’t yet know what causes achalasia. It affects about 3,000 people each year.

Achalasia typically occurs later in life—middle-aged and older people are most at risk. If you have an autoimmune disease, you may have a greater risk for contracting achalasia because your body begins to attack healthy cells, particularly the nerves of the esophagus.

Tests and Diagnosis of Achalasia

Your doctor can diagnose achalasia in a number of ways, with the most common being an esophageal manometry. This test involves measuring the muscle contracting in your throat when you try to swallow. Your doctor will also insert a tube into your esophagus to see how well your esophageal sphincter relaxes.

Other tests that are effective include:

Treatment and Care for Achalasia

To cure achalasia, your doctor will try to get your esophageal sphincter to open more easily through either nonsurgical or surgical methods. The most common nonsurgical treatment is pneumatic dilation: your doctor inserts a balloon into the sphincter and inflates it to help it stay open. You can also try Botox injections, which are natural muscle relaxers.

Surgery is a good option for younger people afflicted with achalasia. A Heller myotomy is a procedure during which a surgeon makes a cut into the lower part of the esophageal sphincter, creating an opening for food. Fundoplication, another possible surgical solution, involves taking the upper part of the stomach and wrapping it around the sphincter to pull it tight.

If all else fails, your doctor may prescribe you medications such as nitroglycerin or nifedipine. However, because these have severe side effects, doctors prescribe these as a last resort when other treatments have failed.