The esophagus is a muscular tube that moves swallowed food from your throat to your stomach as part of the process of digestion. At the bottom, there’s a band of muscle called the lower esophageal sphincter that acts as a valve between the esophagus and the stomach. Normally, the action of swallowing causes involuntary muscle contractions that result in the food passing into the stomach. After this happens, the valve closes. When achalasia occurs, the esophagus loses its ability to push food through to the stomach, and the lower esophageal sphincter doesn’t relax. The result is that food and liquid get stuck in the esophagus. This rare condition is caused by nerve damage in the smooth muscles that are in the lower section of the esophagus. This condition worsens over time, as the lower esophageal sphincter tightens and makes swallowing even more difficult.
Common Symptoms of the Disease
- Difficulty swallowing
- Chest pain
- Coughing during eating, or right after
- Regurgitation of undigested food
- Weight loss or dehydration
There are several treatment options for patients suffering from achalasia, though surgical correction provides the best long-term outcomes. Treatments include:
- Botox – Injected into the lower esophageal sphincter using and endoscope, this treatment can provide relief of symptoms for approximately six months.
- Pneumatic Dilation – This treatment uses a balloon-like device to dilate the esophagus.
- Laparoscopic Heller Myotomy and Fundoplication – This procedure has proven the most effective. It divides the muscles of the lower esophageal sphincter, and the provides a type of wrap to prevent acid reflux.
- Per Oral Endoscopic Myotomy (POEM) – This is a new procedure being researched that uses an endoscopic technique to cut the muscle from inside the esophagus, rather than through surgery.
- Lifestyle Changes – To minimize symptoms, it’s important to eat slowly and chew food carefully. Drinking plenty of water is also encouraged. Raising the head of the bed also helps the body empty the esophagus into the stomach. Avoid foods that cause reflux.