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What is achalasia?

Achalasia is a disease that affects the esophagus and causes problems with swallowing and eating. The esophagus is a muscular tube that carries food and fluid from the back of the throat to the stomach. Normally, the lower esophageal sphincter (LES) is a muscle around the lower part of the esophagus that typically contracts to prevent food and fluid from coming up from the stomach into the esophagus and typically relaxes upon swallowing in order to let food and fluid into the stomach while eating. Patients who have achalasia have failure of the LES to open during swallowing. This leads can lead to the backup of food and fluid within the esophagus. 

What causes achalasia?

Achalasia is caused by the degeneration of nerves in your esophagus. While the triggers for this damage to the nerves are still being understood, some specific types of infections are associated with this disease and may be responsible for the disease. In most cases, the trigger is not identified.

What are the symptoms of achalasia?

Patient with achalasia will often have trouble swallowing or feel like food is stuck in their esophagus. Some patients think they may be experiencing heartburn, but the discomfort is actually coming from the fluid and food backing up in the chest and not from reflux. Symptoms of achalasia include:

  • Trouble swallowing
  • Choking
  • Coughing
  • Pain or discomfort in the chest
  • Fullness or tightness in the lower chest after eating
  • Significant drooling at night

Advanced disease may also lead to:

  • Weight loss
  • Shortness of breath from aspiration of contents from the esophagus

How is achalasia diagnosed?

If you have trouble swallowing both solids and liquids, and it gets worse over time, your physician may suspect you have achalasia. ​