Esophageal achalasia; Swallowing problems for liquids and solids; Cardiospasm - lower esophageal sphincter spasm
The 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.
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.
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.
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:
Your health care provider can help you decide which treatment is best for you.
The outcomes of surgery and non-surgical treatments are similar. More than one treatment is sometimes necessary.
Complications may include:
Contact your provider if:
Many of the causes of achalasia cannot be prevented. However, treatment may help to prevent complications.
Falk 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.BACK TO TOP
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.
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