Achalasia: Types, Causes, Symptoms, Diagnosis & Treatment

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What is Achalasia?

The esophageal muscles are affected in the extremely rare disorder known as achalasia, which makes swallowing food and liquids difficult. The Greek roots of the word “achalasia” indicate “incapacity to unwind.” Failure of the lower esophageal sphincter (LES), a ring-shaped muscle at the end of the esophagus, to relax and open normally when food or liquid has to flow into the stomach, is what this condition is referred to as.

There are three types of Achalasia – Type I, II and III each characterized by different symptoms. Type I is considered classic achalasia while type II is known as vigorous achalasia. Type III is also called spastic achalasia or jackhammer esophagus.

The exact cause of Achalasia remains unknown but researchers believe it may be due to an autoimmune response which attacks nerve cells in the esophagus leading them not functioning correctly.

Common symptoms associated with Achalasia include difficulty swallowing food, chest pain or discomforts during eating, regurgitation of undigested foods after meals among others.

In most cases, doctors will look at patient records, perform a physical exam, and order diagnostic tests like X-rays of a barium swallow or an endoscopy to arrive at a diagnosis.

Types of Achalasia

Achalasia is not a one-size-fits-all condition. There are three different types of Achalasia, each with its own unique characteristics and treatment options.

  • Type 1 achalasia is the most prevalent form, and it often manifests itself in those older than 20. Symptoms include chest pain, regurgitation of food, and trouble swallowing both solids and liquids. The inability of the LES to relax normally causes a blockage that prevents food from entering the stomach.
  • Type 2 achalasia affects a smaller portion of individuals diagnosed with this condition. Unlike Type 1, it primarily affects younger people under the age of 40 years old. In addition to difficulty swallowing and regurgitation symptoms seen in Type 1 patients, there’s also increased pressure within the LES.
  • Type 3 achalasia mimics other gastrointestinal disorders such as reflux disease or gastroparesis because it presents more digestive complaints than Types I & II . This subtype has significant weight loss due to poor digestion; therefore doctors should rule out other conditions before confirming its diagnosis for best management.

Knowing what type you have can help guide your medical team towards proper symptom control measures for optimal relief from your symptoms so make sure you get correctly diagnosed by seeking appropriate professional advice!

Causes of Achalasia

Although the precise etiology of Achalasia is unknown, there are a number of factors that researchers and clinicians feel may play a role. An autoimmune disorder in which the body’s immune system inappropriately assaults healthy esophageal cells is a possible cause of this condition.

An abnormal nerve in the esophagus could also be to blame for this condition, as it would hinder the muscle from relaxing and contracting as it should when swallowing. Possible causes of this nerve’s dysfunction include injury and degeneration.

Achalasia may have a genetic component; those with a family history of the disorder are more likely to have the symptoms themselves, according to some research.

Viral infections and environmental pollutants are two more possible triggers. Despite the existence of these hypotheses, the specific cause of Achalasia remains unknown. To have a deeper understanding of this illness, more research is required.

Symptoms of Achalasia

Achalasia is an extremely uncommon condition that hinders the esophagus’s capacity to transport food to the stomach. Its symptoms can severely impair a person’s ability to function and lead a normal life.

Dysphagia, or difficulty swallowing, is the hallmark of Achalasia. This typically involves solid foods at first, but it can go on to liquids. It can be painful and uncomfortable to have food stuck in your throat or chest.

Regurgitation, in which partially digested meals are regurgitated back into the mouth, is another sign of Achalasia. Choking or aspiration pneumonia can result if any particulate matter is breathed in.

Acid from the stomach can back up into the esophagus and cause irritation and inflammation, resulting in heartburn. Some people with Achalasia also report suffering chest pain.

Due to the difficulty and discomfort associated with eating, people with Achalasia may experience weight loss as a result of eating less.

If you’re experiencing any of these symptoms, it’s critical that you consult a doctor right away so that they can run diagnostic tests and determine the best course of therapy for you.

Diagnosis of Achalasia

Achalasia is difficult to diagnose since its symptoms overlap with those of other digestive illnesses. A barium swallow is an X-ray test your doctor may recommend if you have trouble swallowing or regurgitation of meals. In order to examine the mobility of the liquid, an X-ray will be taken while you drink a liquid containing barium that coats the esophagus and stomach.

Esophageal manometry, which measures pressure in the esophagus at various points, is another diagnostic tool for achalasia. Muscle contractions during swallowing can be recorded by inserting a small tube containing sensors through the nose and into the esophagus.

To perform an endoscopy, a flexible tube fitted with a tiny camera is inserted down a patient’s throat and used to view the stomach and esophagus.

Doctors may order imaging tests like a CT scan or MRI to rule out more serious causes of the patient’s symptoms, like GERD or a tumor.

Finding effective treatment for Achalasia requires a correct diagnosis. If you have trouble swallowing or regurgitating food, you should seek the advice of qualified medical authorities.

Treatment of Achalasia

The goal of treating Achalasia is to alleviate the pressure on the lower esophageal sphincter and improve dysphagia symptoms. The intensity and form of achalasia will determine the best course of treatment.

Milder cases may benefit from drugs like calcium channel blockers or nitrates, which help relax the muscles of the esophagus and make swallowing easier.

Pneumatic dilation is a minimally invasive treatment used for mild to severe instances. Sedated patients have a balloon inflated within their esophagus to widen the passageway.

Laparoscopic Heller myotomy is a surgical procedure in which a tiny incision is created in the abdomen and a portion of the LES muscle is severed.

Endoscopic injection of botulinum toxin can also be used as an alternative treatment. During this procedure, Botox injections are given directly into the LES muscles that cause them to relax temporarily and allow better movement of food through your digestive tract.

All treatments have risks involved; therefore consulting with a doctor will determine which one suits you best.

Complications of Achalasia

Achalasia can lead to several complications if left untreated or not managed properly. One of the most common complications is regurgitation, which occurs when food and liquids flow back into the esophagus from the stomach due to a weak lower esophageal sphincter (LES). This can cause chest pain, heartburn, and difficulty breathing.

Aspiration pneumonia is another issue that can arise if food or drink is inhaled instead than swallowed. Aspiration pneumonia is potentially fatal and needs emergency medical care right once.

Achalasia has been linked to an increased risk of esophageal cancer in extremely rare situations. Swallowing difficulties can put persistent pressure on the esophagus, which can damage the lining cells and generate abnormal growths that could turn malignant.

Furthermore, some people with achalasia may experience weight loss and malnutrition as they have trouble eating normally. They might need specialized diets or supplements to maintain their nutritional needs.

It’s essential for individuals with achalasia to seek proper treatment and management as soon as possible to avoid these potential complications.

Prevention of Achalasia

Since the root cause of Achalasia is yet unknown, prevention is not always an option. However, there are measures that could lessen the danger and stop complications from occurring.

Preventing achalasia may be aided by keeping a healthy weight through exercise and a balanced diet. One possible cause of achalasia is acid reflux, which can be exacerbated by being overweight or obese due to the added strain on the esophagus and stomach.

You can reduce your risk of acquiring achalasia by not smoking and not drinking excessively. Both activities cause long-term injury to the esophageal smooth muscle due to repeated irritation of the esophageal lining.

In addition, autoimmune illnesses including scleroderma and Chagas disease, which are known to increase the risk of developing achalasia, should be treated.

Seek quick medical assistance if you suffer from regular heartburn or have trouble swallowing food to prevent the onset of more serious conditions like Achalasia. Managing symptoms and increasing quality of life can be greatly aided by prompt diagnosis and therapy.


Achalasia is a severe, albeit uncommon, disorder of the esophagus. It can negatively impact one’s quality of life by causing difficulties with swallowing and other unpleasant symptoms.

If you suffer any of the signs and symptoms of this illness, you must consult a doctor immediately. Preventing additional consequences requires prompt diagnosis and treatment.

Medication, lifestyle adjustments, and surgery are all viable methods for treating Achalasia. Disease severity, age, and general health all play a role in determining the best course of treatment.

Prevention measures are not yet known for Achalasia since it is a rare condition with unknown causes. However, maintaining good oral hygiene practices may help alleviate some discomforts caused by the disease.

If you suspect that you have Achalasia or have been diagnosed with it already, remember to follow your doctor’s advice strictly throughout your treatment journey. With proper care management from a healthcare professional team, those affected by this illness can live comfortable lives while minimizing their risks for severe consequences like cancer development or aspiration pneumonia due to food regurgitation into airways during swallowing difficulties experiences commonly seen in advanced stages of achalsia

Always be aware that early detection leads to better outcomes when managing chronic conditions like achalsia!



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