BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAchalasiaEsophageal achalasia; Swallowing problems for liquids and solids; Cardiospasm - lower esophageal sphincter spasmThe tube that carries food from the mouth to the stomach is the esophagus or food pipe. Achalasia makes it harder for the esophagus to move food into the stomach. Causes There is a muscular ring at the point where the esophagus and stomach meet. It is called the lower esophageal sphincter (LES). Normally, this muscle relaxes when you swallow to allow food to pass into the stomach. In people with achalasia, it does not relax as it should. In addition, the normal muscle activity of the esophagus (peristalsis) is reduced or absent.This problem is caused by damage to the nerves of the esophagus.Other problems can cause similar symptoms, such as cancer of the esophagus or upper stomach, and a parasite infection that causes Chagas disease, which is more common in Mexico and Central and South America.Chagas diseaseChagas disease is an illness caused by tiny parasites and spread by insects. The disease is common in South and Central America.ImageRead Article Now Book Mark Article Achalasia is rare. It may occur at any age, but is most common in people ages 25 to 60. In some people, the problem may be inherited. Symptoms Symptoms include:Backflow (regurgitation) of food Chest pain, which may increase after eating, or may be felt as pain in the back, neck, and arms Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Cough Difficulty swallowing liquids and solids Heartburn HeartburnHeartburn is a painful burning feeling just below or behind the breastbone. Most of the time, it comes from the esophagus. The pain often rises in ...ImageRead Article Now Book Mark Article Unintentional weight loss Exams and Tests Physical exam may show signs of anemia or malnutrition.AnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article MalnutritionMalnutrition is the condition that occurs when your body does not get enough nutrients.ImageRead Article Now Book Mark Article Tests include:Manometry, a test to measure if your esophagus is working properly. ManometryEsophageal manometry is a test to measure how well the esophagus is working.ImageRead Article Now Book Mark Article EGD or upper endoscopy, a test to examine the lining of the stomach and esophagus. It uses a flexible tube and camera. EGDEsophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus, stomach, and first part of the small intestine (the duodenum)....ImageRead Article Now Book Mark Article Upper GI x-ray.Upper GI x-rayAn upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test th...ImageRead Article Now Book Mark Article Treatment The goal of treatment is to reduce the pressure at the sphincter muscle and allow food and liquids to pass easily into the stomach. Therapy may involve:Injection with botulinum toxin (Botox) -- This may help relax the sphincter muscles. However, the benefit wears off within a few weeks or months. Medicines, such as long-acting nitrates or calcium channel blockers -- These drugs can be used to relax the lower esophagus sphincter. But there is rarely a long-term solution to treat achalasia. Surgery (called a myotomy) -- In this procedure, the lower sphincter muscle is cut. This procedure is usually performed using a laparoscope. Widening (dilation) of the esophagus -- This is done during EGD by stretching the LES with a balloon dilator.Your health care provider can help you decide which treatment is best for you. Outlook (Prognosis) The outcomes of surgery and non-surgical treatments are similar. More than one treatment is sometimes necessary. Possible Complications Complications may include:Backflow (regurgitation) of acid or food from the stomach into the esophagus (reflux) Breathing food contents into the lungs (aspiration), which can cause pneumonia Tearing (perforation) of the esophagus When to Contact a Medical Professional Contact your provider if:You have trouble swallowing or painful swallowing Your symptoms continue, even with treatment for achalasia Prevention Many of the causes of achalasia cannot be prevented. However, treatment may help to prevent complications.Open ReferencesReferencesFalk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.Hamer PW, Lamb PJ. The management of achalasia and other motility disorders of the oesophagus. In: Griffin SM, Lamb PJ, eds. Oesophagogastric Surgery: A Companion to Specialist Surgical Practice. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 16.Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 44.AllVideoImagesTogDigestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationUpper gastrointestinal system - illustration The upper gastrointestinal organs include the mouth, esophagus and stomach.Upper gastrointestinal systemillustrationAchalasia - seriesPresentation Digestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationUpper gastrointestinal system - illustration The upper gastrointestinal organs include the mouth, esophagus and stomach.Upper gastrointestinal systemillustration Achalasia - seriesPresentation Related Information Peristalsis(Special Topic) Review Date: 10/25/2021 Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
AchalasiaEsophageal achalasia; Swallowing problems for liquids and solids; Cardiospasm - lower esophageal sphincter spasmThe tube that carries food from the mouth to the stomach is the esophagus or food pipe. Achalasia makes it harder for the esophagus to move food into the stomach. Causes There is a muscular ring at the point where the esophagus and stomach meet. It is called the lower esophageal sphincter (LES). Normally, this muscle relaxes when you swallow to allow food to pass into the stomach. In people with achalasia, it does not relax as it should. In addition, the normal muscle activity of the esophagus (peristalsis) is reduced or absent.This problem is caused by damage to the nerves of the esophagus.Other problems can cause similar symptoms, such as cancer of the esophagus or upper stomach, and a parasite infection that causes Chagas disease, which is more common in Mexico and Central and South America.Chagas diseaseChagas disease is an illness caused by tiny parasites and spread by insects. The disease is common in South and Central America.ImageRead Article Now Book Mark Article Achalasia is rare. It may occur at any age, but is most common in people ages 25 to 60. In some people, the problem may be inherited. Symptoms Symptoms include:Backflow (regurgitation) of food Chest pain, which may increase after eating, or may be felt as pain in the back, neck, and arms Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Cough Difficulty swallowing liquids and solids Heartburn HeartburnHeartburn is a painful burning feeling just below or behind the breastbone. Most of the time, it comes from the esophagus. The pain often rises in ...ImageRead Article Now Book Mark Article Unintentional weight loss Exams and Tests Physical exam may show signs of anemia or malnutrition.AnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article MalnutritionMalnutrition is the condition that occurs when your body does not get enough nutrients.ImageRead Article Now Book Mark Article Tests include:Manometry, a test to measure if your esophagus is working properly. ManometryEsophageal manometry is a test to measure how well the esophagus is working.ImageRead Article Now Book Mark Article EGD or upper endoscopy, a test to examine the lining of the stomach and esophagus. It uses a flexible tube and camera. EGDEsophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus, stomach, and first part of the small intestine (the duodenum)....ImageRead Article Now Book Mark Article Upper GI x-ray.Upper GI x-rayAn upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test th...ImageRead Article Now Book Mark Article Treatment The goal of treatment is to reduce the pressure at the sphincter muscle and allow food and liquids to pass easily into the stomach. Therapy may involve:Injection with botulinum toxin (Botox) -- This may help relax the sphincter muscles. However, the benefit wears off within a few weeks or months. Medicines, such as long-acting nitrates or calcium channel blockers -- These drugs can be used to relax the lower esophagus sphincter. But there is rarely a long-term solution to treat achalasia. Surgery (called a myotomy) -- In this procedure, the lower sphincter muscle is cut. This procedure is usually performed using a laparoscope. Widening (dilation) of the esophagus -- This is done during EGD by stretching the LES with a balloon dilator.Your health care provider can help you decide which treatment is best for you. Outlook (Prognosis) The outcomes of surgery and non-surgical treatments are similar. More than one treatment is sometimes necessary. Possible Complications Complications may include:Backflow (regurgitation) of acid or food from the stomach into the esophagus (reflux) Breathing food contents into the lungs (aspiration), which can cause pneumonia Tearing (perforation) of the esophagus When to Contact a Medical Professional Contact your provider if:You have trouble swallowing or painful swallowing Your symptoms continue, even with treatment for achalasia Prevention Many of the causes of achalasia cannot be prevented. However, treatment may help to prevent complications.Open ReferencesReferencesFalk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.Hamer PW, Lamb PJ. The management of achalasia and other motility disorders of the oesophagus. In: Griffin SM, Lamb PJ, eds. Oesophagogastric Surgery: A Companion to Specialist Surgical Practice. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 16.Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 44.