Achalasia is a condition in which the muscles of the esophagus lose the ability to properly conduct food from the mouth to the stomach. Achalasia could occur when the nerves in the esophagus get damaged and the esophageal muscles may dilate or become weak. The food could get partially held back in the esophagus, and the patient may experience regurgitation.
Signs and symptoms of Achalasia
Achalasia symptoms usually start mild and worsen over time, including – inability to swallow to both solid and liquid foods, belching, regurgitation or vomiting, heartburn, intermittent chest pain, unexplained weight loss and pneumonia (from food aspiration into the lungs).
Causes and risk factors of Achalasia
The exact causes of achalasia are still not well-understood. The specific cause varies for different cases. The condition could be hereditary, due to viral infection, auto-immune response or degeneration of nerves. Esophageal cancer could cause pseudo-achalasia. Middle-aged and older patients, as well as patients with auto-immune conditions, are at a higher risk of achalasia.
Complications of Achalasia
Achalasia has no cure but the condition can be managed with medications, minimally-invasive therapies and surgical interventions if diagnosed early.
Diagnosis of Achalasia
Achalasia is usually diagnosed in one of the following ways – Esophageal manometry, X-ray or endoscopy of the esophagus, or a barium swallow test. The barium swallow test is done by asking the patient to swallow barium in a safe, liquid form and tracking its path through the esophagus using X-rays.
Treatment and Surgical Interventions of Achalasia
Achalasia in mild or early cases can be treated by a host of non-surgical options – Pneumatic dilation with a balloon, Botox or muscle relaxants. Myotomy (dividing LES) offers a high success rate and durable response to Achalasia cardia. Conventionally myotomy is performed surgically which is known as Heller’s Myotomy. A newer non-surgical, endoscopic procedure is called POEM (Per Oral Endoscopic Myotomy) is equivalent to surgical myotomy.
Prevention of Achalasia
Since the causes of achalasia are not well-known, there are no generally accepted preventive measures.