Conditions that can lead to
esophageal motility problems
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.
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
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.
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.
For more information, call 1.866.CALL.MLH.