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Achalasia is a disorder of the esophagus that prevents normal swallowing.

Achalasia affects the esophagus, the tube that carries food taken from the back of the throat to the stomach. A ring of muscle called the lower esophageal sphincter encircles the esophagus just above the entrance to the stomach. This sphincter muscle is normally contracted to close the esophagus.

When the sphincter is closed, the stomach contents can not flow into the esophagus. The reflux can irritate and inflame the esophagus, causing symptoms such as heartburn. The act of swallowing causes a wave of esophageal contraction called peristalsis. Peristalsis pushes food along the esophagus. Normally, peristalsis causes the esophageal sphincter to relax and allow food into the stomach. In achalasia, the LES still remains contracted. Normal peristalsis is interrupted and the food can not enter the stomach.

Symptoms

Dysphagia, or difficulty swallowing, is the most common symptom of achalasia. The person with achalasia usually has trouble swallowing solids and liquids and has the feeling that food “gets stuck” in the background. The person has chest pain that is often confused with angina pectoris (cardiac pain). Heartburn and difficulty belching are common. Symptoms usually get worse. Other symptoms may include nighttime cough or recurrent pneumonia caused by food passing through the lower respiratory tract.

Causes

Achalasia is caused by degeneration of nerve cells that normally give signals to the brain to relax the esophageal sphincter. The ultimate cause of this degeneration is unknown. Suspected of an autoimmune disease or an occult infection.

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