Achalasia is a medical condition of the esophagus that prevents the patient from being able to swallow properly.

Patients with achalasia experience great difficulty in swallowing food. Although this condition can become very serious, it is rare and it can be managed.

What Causes It?

Achalasia is caused by the failure of the esophagus to properly move food to the stomach. Normally when a person swallows food, the muscles of the esophagus will move the food down to the lower esophageal sphincter, or LES. This sphincter is a ring that separates the lower esophagus from the stomach. Typically, this LES will open when food is taken in. In the case of patients with achalasia, this process fails. This can be either because the nerves of the esophagus are damaged or because the LES is directly damaged. This damage is sometimes the result of genetics but is often caused by the presence of an autoimmune disease. For this reason, achalasia is most commonly seen in adults who have reached or passed middle-age.

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What Are The Symptoms?

The most predominant symptom of achalasia is dysphagia, which is difficulty swallowing. This means that these patients often feel as if their food is caught in their throat. This symptom is really the root of the majority of the symptoms associated with achalasia. For example, when dysphagia is experienced, then the patient is likely to experience chest pain. Additionally, dysphagia can lead to the very serious of aspiration, which is the inhalation of food. If these symptoms occur often enough, the patient is likely to decrease the frequency with which they eat and consequently lose weight or become malnourished. Some of the more mild symptoms include reflux or regurgitation, which may look like GERD, so it is important that these symptoms and their cause are fully investigated.

How Is It Diagnosed?

Of course, the first step to receiving any diagnosis is for the patient to accurately report any and all symptoms to their physician. The physician then will need to perform a number of diagnostic procedures in order to rule out other possible diagnoses. They will likely utilize either X-ray or CT scan technology in order to get images of the esophagus. However, an endoscopy will provide them with more detailed images of this internal structure because it involves the insertion of a camera on a tube down the esophagus. This procedure doesn’t take long and comes with minimal risk but it can provide a lot of information about the condition of the esophagus and sphincter.

Another critical test is the barium swallow test, which consists of the patient swallowing barium and the physician tracking its travel down the esophagus. The physician may also run an esophageal manometry, which also involves the insertion of a tube down the esophagus, similar to the process involved in an endoscopy. However, this tube records the muscle activity throughout providing the physician with a better idea of the functionality of the structures.