What is achalasia?
Achalasia is a rare condition that makes it difficult for food and liquids to pass from the esophagus into the stomach. Normally, the muscles of the esophagus push food downward, and a ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter (LES), relaxes to allow food into the stomach.

With achalasia, the muscles of the esophagus do not work properly, and the lower esophageal sphincter does not relax as it should. This prevents food and liquids from moving easily into the stomach.

Achalasia is a chronic condition, but treatment can significantly improve swallowing, reduce symptoms and improve quality of life.

What causes achalasia?
The exact cause of achalasia is not fully understood. It is believed to occur when the nerves that control the muscles of the esophagus become damaged, preventing normal muscle contractions and relaxation of the lower esophageal sphincter.

Symptoms of achalasia
The most common symptom is difficulty swallowing food and liquids.

Other symptoms may include:

  • Chest pain
  • Heartburn
  • A feeling that food is stuck in the throat or chest
  • Regurgitation of food or liquids
  • Hiccups
  • Unintentional weight loss

Symptoms often develop gradually and may worsen over time if left untreated.

Diagnosing achalasia
Your provider will review your symptoms and medical history and may recommend testing to confirm the diagnosis.

Testing may include:

  • Upper endoscopy (EGD)
  • Barium swallow (esophagram)
  • High-resolution esophageal manometry

High-resolution esophageal manometry is considered the most accurate test for diagnosing achalasia because it measures how well the muscles of the esophagus contract and whether the lower esophageal sphincter relaxes properly.

Treatment for achalasia
Treatment focuses on improving swallowing by helping the lower esophageal sphincter relax and allowing food to pass into the stomach more easily.

Treatment options may include:

  • Medications to relax the lower esophageal sphincter
  • Botox® injections into the lower esophageal sphincter
  • Pneumatic (balloon) dilation
  • Peroral endoscopic myotomy (POEM)
  • Heller myotomy surgery

Your provider will recommend the treatment option that is best based on your symptoms, overall health, and the severity of your condition.

When to seek care
Talk with your healthcare provider if you experience:

  • Difficulty swallowing food or liquids
  • Chest pain
  • Persistent heartburn
  • Food coming back up after swallowing
  • Unintentional weight loss

Early evaluation and treatment can help prevent complications and improve your quality of life.

Contact us
If you have questions about achalasia or treatment options, please contact our office at 612-871-1145.