Esophageal achalasia; Swallowing problems - achalasia; Lower esophageal sphincter; LES; Myotomy
The tube that carries food from the mouth to the stomach is the esophagus. 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 well. In addition, the normal muscle activity of the esophagus (peristalsis) is reduced.
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.
Achalasia is rare. It may occur at any age, but is most common in middle-aged or older adults. 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:
Call 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's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 138.
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. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 43.
Last reviewed on: 10/27/2015
Reviewed by: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.