It is a rare condition that affects the ability of the esophagus to move food and liquids to the stomach. It occurs when the muscles of the lower esophageal sphincter (LES) don’t relax properly, making it difficult for food and liquid to pass through. This condition can cause discomfort, pain, and difficulty eating, and can ultimately lead to serious complications if left untreated.
Symptoms of Achalasia
The common symptoms of achalasia include:
- Difficulty swallowing: Patients may experience difficulty swallowing both liquids and solids and may feel as if food is getting stuck in their chest or throat. This may cause them to cough or choke while eating or drinking.
- Regurgitation: Patients may experience regurgitation of food and liquid, which means that the contents of their stomach may come back up into their mouth.
- Chest pain: Patients may experience chest pain or discomfort, which may feel like heartburn or indigestion.
- Weight loss: Patients may experience unintentional weight loss as a result of their difficulty swallowing and reduced food intake.
- Heartburn: Patients may experience heartburn or acid reflux, which is a burning sensation in the chest caused by stomach acid flowing back up into the esophagus.
- Chronic cough: Patients may experience a chronic cough, which is caused by irritation of the airways due to regurgitated food and liquid.
- Fatigue: Patients may experience fatigue due to reduced nutrient intake and disrupted sleep from nighttime regurgitation.
Etiology of Achalasia
The cause of achalasia is not yet fully understood, but it is believed to be due to an autoimmune response or a degeneration of the nerves in the esophagus. The condition can affect people of all ages and genders, although it is most commonly diagnosed in individuals between the ages of 25 and 60.
Diagnosis of achalasia
The diagnosis of achalasia involves several steps:
- Physical examination: Your doctor will examine your abdomen and listen to your chest to check for abnormal sounds.
- Imaging tests: Imaging tests such as X-rays or CT scans may be ordered to check the esophagus and rule out other conditions.
- Endoscopy: A thin, flexible tube with a camera on the end (endoscope) may be inserted through your mouth to look for any abnormalities in the esophagus.
- Barium swallow: A barium swallow test involves drinking a liquid containing barium, which then shows up on an X-ray and allows doctors to see the shape and function of the esophagus
- Esophageal Manometry: This test measures the pressure inside your esophagus and helps to determine if the LES is functioning normally. Esophageal manometry involves placing a small tube through the nose and into the esophagus to measure the pressure and movement of the muscles.
Treatment of Achalasia
Treatment options for achalasia vary depending on the severity of the condition but typically involve a combination of lifestyle changes and medical intervention.
Lifestyle changes such as eating smaller, more frequent meals and avoiding foods that are difficult to swallow can help alleviate symptoms.
Medications can be used to help relax the lower esophageal sphincter (LES), which is the muscle that controls the flow of food into the stomach. The following medications may be used to treat achalasia:
- Calcium channel blockers: These medications help to relax smooth muscles, including the LES. Nifedipine and verapamil are examples of calcium channel blockers that may be used to treat achalasia.
- Nitroglycerin: Nitroglycerin is a medication that is typically used to treat angina (chest pain). However, it can also be used to help relax the LES and improve swallowing in people with achalasia.
- Botulinum toxin (Botox): Botox can be injected directly into the LES to help relax the muscle and improve swallowing. This treatment is typically used in people who are not good candidates for surgery.
Conclusion
Overall, achalasia is a complex condition that can cause significant discomfort and lead to serious complications if left untreated. Early diagnosis and treatment are crucial in managing symptoms and preventing further damage to the esophagus. If you are experiencing symptoms of achalasia, it is important to speak with your healthcare provider to determine the best course of action for your individual needs.