Achalasia is a disorder of the tube that carries food from the mouth to the stomach (esophagus), which affects the ability of the esophagus to move food toward the stomach.
A muscular ring at the point where the esophagus and stomach come together (lower esophageal sphincter) normally relaxes during swallowing. In people with achalasia, this muscle ring does not relax as well. The reason for this problem is damage to the nerves of the esophagus.
Cancer of the esophagus or upper stomach and a parasite infection that causes Chagas disease may have symptoms like those of achalasia.
Achalasia is a rare disorder. It may occur at any age, but is most common in middle-aged or older adults. This problem may be inherited in some people.
Physical examination may show signs of anemia or malnutrition.
Tests include:
The approach to treatment is to reduce the pressure at the lower esophageal sphincter. Therapy may involve:
Your doctor can help you decide which treatment is best for your situation.
The outcomes of surgery and nonsurgical treatments are similar. Sometimes more than one treatment is necessary.
Call your health care provider if:
Many of the causes of achalasia are not preventable. However, treatment of the disorder may help to prevent complications.
Esophageal achalasia
Orlando RC. Diseases of the esophagus. In: Goldman L, Ausiello DA, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 140.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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