Achalasia

Achalasia is a rare condition that makes swallowing difficult. Early evaluation is crucial, as timely diagnosis and treatment can help prevent complications and improve comfort.

medical illustration of the esophagus showing the hallmark signs of achalasia

What is Achalasia?

Achalasia affects the esophagus, the muscular tube that carries food from your mouth to your stomach. In a healthy esophagus, a ring of muscle at the bottom, called the lower esophageal sphincter (LES), relaxes to allow food to pass into the stomach.

For individuals with achalasia, two key problems occur:

  1. The nerves in the esophagus are damaged, which prevents the normal, wave-like muscle contractions (peristalsis) that move food along.
  2. The lower esophageal sphincter (LES) fails to relax properly, effectively trapping food in the esophagus.

This combination of issues can make swallowing difficult and painful, leading to a range of uncomfortable symptoms and potential health complications if left untreated.

Symptoms of Achalasia

Symptoms of achalasia often develop gradually and can worsen over time. Because they can mimic other digestive conditions like GERD, a precise diagnosis from a gastroenterology specialist is essential.

Common symptoms include:

  • Dysphagia: The primary symptom, which is the sensation of food or liquid getting stuck in your chest.
  • Regurgitation: The return of undigested food from the esophagus, which can occur after meals or while lying down.
  • Chest Pain: A feeling of pressure, discomfort, or spasms in the chest, often unrelated to eating.
  • Heartburn: A burning sensation in the chest that does not improve with standard antacids.
  • Unintentional Weight Loss: Difficulty eating and poor nutrient absorption can lead to significant weight loss.
  • Coughing or Choking: Especially when lying down, as regurgitated food can enter the windpipe. 

Diagnosing Achalasia

A timely and accurate diagnosis is the first step toward effective treatment. Our board certified gastroenterologists utilize state-of-the-art diagnostic technology to evaluate esophageal function and confirm achalasia.

A thin, flexible tube with a camera is passed down the throat to visually inspect the esophagus and stomach. This helps rule out other conditions and may show retained food or a tight LES.

This is the most reliable test for diagnosing achalasia. During the test, a thin, flexible, pressure-sensitive tube (catheter) is inserted through the nose into the esophagus to measure the pressure and movements of the esophageal muscles.

For this X-ray study, you swallow a liquid containing barium. The barium coats the lining of your esophagus, allowing our team to observe its shape and how it empties. With achalasia, this test often reveals a dilated esophagus that tapers to a "bird's beak" shape at the bottom.

Advanced Achalasia Treatment Options 

While there is no cure for achalasia, several highly effective treatments are available to manage symptoms by opening the lower esophageal sphincter.

A non-surgical procedure performed during an endoscopy. A balloon is inserted into the center of the lower esophageal sphincter and inflated to stretch and disrupt the muscle fibers, allowing food to pass more easily.

For patients who may not be candidates for more permanent procedures, an injection of Botox® into the LES during an endoscopy can help relax the muscle. The effects are temporary, typically lasting for several months.

A minimally invasive surgical procedure where the surgeon cuts the muscle fibers of the LES. This is often combined with a fundoplication (anti-reflux surgery) to prevent future issues with heartburn.

A cutting-edge, incisionless procedure. An endoscope is passed through the mouth to create a tunnel within the esophageal wall, allowing the surgeon to cut the LES muscle from the inside. This is a highly effective option with a quicker recovery time.

 

Achalasia Care in Westlake or Brooklyn, OH

At North Shore Gastroenterology, we provide expert diagnosis and compassionate care for patients with achalasia and other complex esophageal motility disorders. Contact our Westlake or Brooklyn, OH, locations at (440) 808-1212 or request an appointment online to schedule a visit.