Achalasia is a swallowing disorder caused by loss of function in the esophageal body and the lower esophageal sphincter (the muscular ring at the junction of the esophagus and the stomach). Normally, when people swallow the esophageal body will sequentially contact and, the sphincter relaxes to allow food and liquid to pass into the stomach. With achalasia, the esophageal body do not contact and the sphincter does not relax, which causes food to be lodged in that area.

Many medical experts believe that the degeneration of the nerve cells that signal the brain to relax the esophageal body and the esophageal sphincter causes achalasia. Although the underlying cause of this degeneration is unknown, some have proposed an autoimmune disease or infectious source.
Symptoms usually worsen over time, leading to the person not tolerating both solids and liquids diet. These symptoms include:
Usually suspected based upon the presence of the symptoms described above, but specific tests are needed to confirm the diagnosis and to rule out other conditions with similar symptoms such as the following investigations:
  1. Endoscopy
  2. Barium swallow x-ray
  3. Esophageal Manometry
  4. Computerized Tomography Scan (CT Scan)
  5. 24 hrs. pH – impedance monitoring
The aim of treatment is to allow food to pass through more easily, using medication, balloon dilation, surgery or endoscopic treatment (Botulinum toxin injection). Occasionally, medications such as calcium channel blockers or nitrate-based compounds will help relieve symptoms of achalasia, but these treatments are generally ineffective in most patients.

Balloon Pneumatic dilation involves the insertion of an inflatable balloon down the esophagus to the sphincter, where it is inflated to force the sphincter open. This is effective in about 70-80% of patients but multiple sessions are often required, there is the risk of esophageal perforation.

The surgery to relieve achalasia is called an esophageal myotomy after which about 80-85% of patients experience long-term relief. This involves dividing the muscularis of the upper stomach and the lower esophagus.

Nutrition plays an important role prior to, and in conjunction with, these procedures. A dietitian will most likely recommend foods or liquids that are calorie dense and easily swallowed.

Achalasia is an uncommon disorder of the esophagus that your physician may treat with any treatment options which previously mentioned base on the individual patient.
Since the cause of achalasia is not known, the condition is not preventable. Early treatment, however, can lessen the chance of complications.

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