Achalasia

Definition

The tube that carries food from the mouth to the stomach is the esophagus or food pipe. Achalasia makes it harder for the esophagus to move food into the stomach.

Causes

There is a muscular ring at the point where the esophagus and stomach meet. It is called the lower esophageal sphincter (LES). Normally, this muscle relaxes when you swallow to allow food to pass into the stomach. In people with achalasia, it does not relax as well. In addition, the normal muscle activity of the esophsagus (peristalsis) is reduced.

This problem is caused by damage to the nerves of the esophagus.

Other problems can cause similar symptoms, such as cancer of the esophagus or upper stomach, and a parasite infection that causes Chagas disease.

Achalasia is rare. It may occur at any age, but is most common in people ages 25 to 60. In some people, the problem may be inherited.

Symptoms

Symptoms include:

Exams and Tests

Physical exam may show signs of anemia or malnutrition.

Tests include:

Treatment

The goal of treatment is to reduce the pressure at the sphincter muscle and allow food and liquids to pass easily into the stomach. Therapy may involve:

Your health care provider can help you decide which treatment is best for you.

Outlook (Prognosis)

The outcomes of surgery and non-surgical treatments are similar. More than one treatment is sometimes necessary.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your provider if:

Prevention

Many of the causes of achalasia cannot be prevented. However, treatment may help to prevent complications.


Review Date: 10/25/2017
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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