Achalasia is a rare disorder of the esophagus that affects the ability of the esophagus to move food toward the stomach. It may occur at any age, but is typically more common in middle-aged and older persons. It may be inherited, as well. When people have achalasia, the muscles in their esophagus and the valve that allows food to pass into and remain in the stomach do not work properly.
Because achalasia is a difficult condition to diagnose and is often mismanaged, many believe it is best diagnosed and treated by doctors who specialize in treating it. Esophageal cancer and stomach cancer, as well as Chagas disease may cause symptoms similar to achalasia.
What Causes Achalasia?
The esophagus has two muscular rings, the upper and lower esophageal sphincters. The lower one relaxes during swallowing, allowing food to pass into the stomach. Damage to the nerves of the esophagus causes the lower esophageal sphincter to not relax.
Signs & Symptoms
The following symptoms are common with achalasia:
- Regurgitation (backflow) of food
- Chest pain (typically increases after eating), felt in the back, neck and arms
- Dry cough
- Difficulty swallowing both solids and liquids
- Unintended weight loss
Diagnosis & Testing
Your doctor may conduct a physical examination, using some of the following tests:
- Esophageal manometry: this test measures the pressure inside the lower part of the esophagus. A thin, pressure-sensitive tube is placed in your esophagus, and measures the pressure as you swallow. This test takes approximately 1 hour.
- Esophagogastroduodenoscopy (EGD): this test lets a doctor use a flexible endoscope (thin tube with a camera at the end of it) to examine the lining of the esophagus, stomach, and upper duodenum (first part of the small intestine). The patient is sedated and anesthetized as the test is performed, which takes approximately 5 to 20 minutes.
- Upper GI X-ray: this is an X-ray of the pharynx, esophagus, stomach, and the duodenum. A barium contrast solution is ingested before the X-ray is taken, allowing your doctor to study the condition of the esophagus. In some cases, baking soda crystals may be given to provide sharper imaging.
Surgeons at Northwestern Memorial perform between 50 and 100 surgeries every year to treat achalasia, which is more than any other hospital in Illinois.