Achalasia

Achalasia is a rare esophageal motility disorder that impairs proper swallowing. The lower esophageal sphincter (LES), the muscle that allows food to pass from the esophagus into the stomach, fails to relax properly. In addition, the esophagus loses its normal rhythmic contractions that move food downward.

How Achalasia Affects Swallowing

When the LES does not relax, food and liquid have difficulty entering the stomach. This leads to a buildup of material in the esophagus, causing swallowing difficulties and other symptoms. Over time, the esophagus may become dilated and less effective at moving food.

Symptoms often develop gradually and may worsen over time. Patients commonly have trouble swallowing both solids and liquids, a sensation of food “sticking” in the chest, regurgitation of undigested food, chest discomfort, chronic cough, and unintentional weight loss. Some individuals may also experience nighttime regurgitation or aspiration.

The exact cause of achalasia is not fully understood. It is believed to result from damage to the nerves that control esophageal muscles. This nerve dysfunction prevents coordinated contractions and proper LES relaxation. In most cases, achalasia develops without a clear trigger, although autoimmune or viral factors may play a role.

Esophageal Manometry

Esophageal manometry is the best method for diagnosing achalasia. This test measures esophageal pressure and muscle contractions to determine whether the LES relaxes properly and whether normal motility is present.

Upper Endoscopy

An upper endoscopy allows direct visualization of the esophagus and stomach. This test helps rule out structural causes of swallowing difficulty and assesses for complications such as inflammation or retained food.

Although achalasia cannot be cured, treatment focuses on relieving symptoms by reducing pressure at the LES. Options may include pneumatic dilation, Botox injections, or minimally invasive surgical procedures such as Heller myotomy or POEM (Peroral Endoscopic Myotomy).

At NYGA, our gastroenterologists specialize in diagnosing and managing complex esophageal disorders. Using advanced motility testing and minimally invasive treatment options, we provide comprehensive care for patients with achalasia.