What is achalasia?

The esophagus is the muscular tube that extends from the neck to the abdomen and connects the throat to the stomach. Achalasia is a condition where the esophagus is unable to move food into the stomach. The lower esophageal sphincter (LES), a valve located at the end of the esophagus, stays closed during swallowing, resulting in the back up of food. Other symptoms include vomiting undigested food, chest pain, heartburn and weight loss..

Who is affected by achalasia?

Achalasia develops in about 3,000 people in the United States each year. It is typically diagnosed in adults, but can occur in children as well. There is no particular race or ethnic group that is affected, and the condition does not run in families.

Is achalasia serious?

Slowly, over a number of years, people with achalasia experience an increasing difficulty in eating solid food and in drinking liquids. As their condition advances, achalasia can cause considerable weight loss and malnutrition. People with achalasia also have a small increase in the risk of developing esophageal cancer, particularly if the obstruction has been present for a long time. Your physician may recommend regular endoscopic screenings for the prevention and early detection of esophageal cancer.

What causes achalasia?

Why esophageal muscles fail to contract normally in people with motility disorders, including achalasia, is unknown. Researchers think it may be linked to a virus, and recent studies show achalasia is caused by nerve cells of the involuntary nervous system within the muscle layers of the esophagus. They are attacked by the patient’s own immune system and slowly degenerate for reasons that are not currently understood.

References:

  • The Society for Thoracic Surgeons. "Achalasia." (2006) www.sts.org/doc/4120 Rice TW, McKelvey AA, Richter JE, Baker ME, Vaezi MF, Feng J, Murthy SC, Mason DP, Blackstone EH. A physiologic clinical study of achalasia: should Dor fundoplication be added to Heller myotomy? J Thorac Cardiovasc Surg, 2005 Dec;130(6):1593-600. Pasricha PJ. "Achalasia." www.uptodate.com