Achalasia – Causes, Symptoms, Diagnosis and Treatment


is an esophageal motility disorder in which the muscle of esophagus loses ability to move food down into the esophagus. The term “achalasia” means “fail to relax” and refers to inability of the muscle to relax or open up. In this article, we shall discuss about achalasia of esophagus.

What causes achalasia

Actual cause of achalasia is still obscure. The esophagus contains both muscles and nerves. Achalasia can be the result of any abnormality in muscle or nerve or both. Theories on the cause of achalasia enumerate some of the reasons as:

Infections, heredity


immune system disorders

that damage normal functioning of esophageal muscle.

Symptoms of achalasia:

  • High difficulty in swallowing both liquids and solids
  • Back flow or regurgitation of food
  • Chest pain that increases after eating
  • The pain may reflect to the back, neck and arms
  • Heartburn
  • Cough
  • Unintentional weight loss

How achalasia is diagnosed

A doctor sees the inside of the esophagus with the help of:

  • Esophageal manometry
  • Esophagogastroduodenoscopy
  • Upper GI X-ray

Apart from this, a physical examination is done to see the signs of anemia and malnutrition.

How achalasia is treated:

First approach to treat the achalasia is to reduce the pressure at the lower esophageal sphincter. Treatment modalities are as following:


Botox injections at the site may help relax the sphincter muscles. This is a short term treatment (for weeks or months).


Wideling or dilatation of esophagus at the site of narrowing is another short term treatment for achalasia.


: Nitrates and calcium channel blockers are used to relax the lower esophagus sphincter.


Surgery of esophagus is called esophagomyotomy. It may be needed in extreme cases to decrease the pressure in the lower sphincter.


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