Achalasia

Achalasia is a rare disorder involving problems with nerve function in the esophagus. As a result, the muscles that normally move food and liquid down to the stomach do not work properly, and the lower esophageal sphincter muscle does not relax and allow food and liquid to pass into the stomach. The cause of achalasia is unknown.

People with achalasia experience problems swallowing both solid foods and liquids. Other symptoms include weight loss, regurgitation, heartburn, and chest pain. The symptoms develop slowly and tend to worsen with time.

Go To:  Diagnosis | Treatments

Diagnosis

If our specialists suspect achalasia based on symptoms or a chest x-ray, further tests will be done to confirm the diagnosis and to rule out other conditions. The evaluation for achalasia typically involves:

• Barium swallow testing. If achalasia is suspected, a barium swallow is helpful in screening for the problem.
• Esophageal manometry. If a barium swallow shows signs of achalasia, esophageal manometry is done to confirm the diagnosis. During the test, a thin flexible tube is inserted into the nose and guided down the esophagus to the stomach. The tube has sensors that measure the strength and coordination of muscle contractions at multiple points in the esophagus during swallowing.
• Upper endoscopy also is performed to rule out other problems that can cause symptoms of achalasia and similar findings on manometry. Upper endoscopy is an examination of the esophagus, stomach, and duodenum (first part of the small intestine) with an endoscope that has been inserted at the mouth.

To schedule an appointment with a Lankenau gastroenterologist, call 866.CALL.MLH or use the online appointment request form.

Treatment

Achalasia cannot be cured, but treatments are available to help open or relax the lower esophageal sphincter and make it easier to swallow. Treatment options offered at Lankenau Medical Center include:

• Balloon dilation (pneumatic dilation). This outpatient procedure is performed with an endoscope and involves the use of a balloon to widen the lower esophageal sphincter.
• Laparoscopic myotomy. This minimally invasive surgical procedure opens up the lower esophageal sphincter.
• Botulinum toxin (Botox) injection. This treatment involves injection of Botox into the lower esophageal sphincter muscle, which relaxes the muscle and prevents spasms.