Achalasia is a condition in which the esophagus is unable to properly transfer food from the mouth to the stomach because of weak esophageal muscles. The cause of achalasia is unknown. It can be treated medically or surgically; however, only surgery has been shown to provide long term relief.
Normally, wave-like muscle contractions (peristalsis) push food down the esophagus to the stomach. At the bottom of the esophagus, the lower esophageal sphincter (LES), a ring-shaped muscle around the esophagus, regulates the entry of food to the stomach by dilating to let food pass through. This action is coordinated with peristalsis. In patients with achalasia, peristaltic waves are weak and the sphincter has difficulty opening. As a result, food remains in the esophagus.
The onset of achalasia is gradual. It is generally diagnosed in patients between 25 and 60 years old, though people of all ages can have it. Achalasia can be diagnosed with esophageal manometry, esophagography (barium swallow), or endoscopy. The doctor may want to perform additional tests to rule out esophageal cancer, GERD, or other conditions.
Achalasia does not go away without treatment, and only surgery has been shown to provide long-term relief. Symptoms may recur even ten years after initial therapy and require repeated treatment.
