Achalasia: Symptoms, Treatment, and Management


Achalasia is a rare esophageal motility disorder characterized by the inability of the lower esophageal sphincter (LES) to relax properly during swallowing. This condition can lead to difficulty in moving food from the esophagus to the stomach. In this article, we will explore the symptoms, treatment options, and management strategies for Achalasia.

Understanding Achalasia:

Achalasia occurs when the nerves in the esophagus and the LES are damaged or dysfunctional, resulting in impaired esophageal peristalsis and LES relaxation. The exact cause of Achalasia is unknown, but it is believed to involve an autoimmune response or degenerative changes in the nerves.

Symptoms of Achalasia:

The hallmark symptom of Achalasia is dysphagia, which is difficulty in swallowing both solids and liquids. Other common symptoms include regurgitation of undigested food, chest pain, and weight loss. Patients may also experience heartburn, nocturnal cough, and recurrent lung infections due to food and liquid reflux.

Diagnosis and Types of Achalasia:

Achalasia is diagnosed through various tests, including esophageal manometry, which measures the pressure and function of the esophagus and LES. Other diagnostic tools include barium swallow studies and endoscopy to rule out other conditions. There are different types of Achalasia, including classic Achalasia, which is the most common form, as well as variant forms like vigorous Achalasia and spastic Achalasia.

Treatment Options:

While there is no cure for Achalasia, several treatment options can help manage the symptoms and improve quality of life. The choice of treatment depends on the severity of symptoms and individual patient factors.

  1. Medications:
    • Nitrates or calcium channel blockers can help relax the LES and improve swallowing function in some cases.
    • Botulinum toxin injection into the LES can temporarily relax the sphincter, providing relief from dysphagia. However, the effects are temporary and may require repeat injections.
  2. Surgical Interventions:
    • Heller myotomy is a surgical procedure that involves cutting the muscle fibers of the LES to facilitate easier passage of food into the stomach.
    • Peroral endoscopic myotomy (POEM) is a minimally invasive procedure that uses an endoscope to access and cut the LES muscle.
    • Esophageal dilation involves stretching the LES using a balloon or dilators to widen the opening and improve swallowing.

Management and Lifestyle Modifications:

Patients with Achalasia can benefit from certain lifestyle modifications, such as eating smaller, more frequent meals, avoiding foods that trigger symptoms, and maintaining an upright position after meals. Some individuals may find it helpful to elevate the head of the bed while sleeping to reduce reflux.

Complications and Follow-up:

If left untreated, Achalasia can lead to complications such as esophageal dilation, weight loss, malnutrition, and aspiration pneumonia. Regular follow-up visits with a healthcare provider are crucial to monitor symptoms, assess treatment effectiveness, and address any concerns.


Achalasia is a rare esophageal motility disorder characterized by difficulty swallowing, regurgitation, and chest pain. While it cannot be cured, various treatment options are available to manage symptoms and improve quality of life. Medications, surgical interventions like Heller myotomy and POEM, and lifestyle modifications can help individuals with Achalasia lead fulfilling lives. Regular follow-up with healthcare providers is essential for monitoring and managing this condition effectively.

Remember, if you experience symptoms of Achalasia, consult with a healthcare professional for accurate diagnosis, personalized treatment options, and ongoing support.

Disclaimer: This article is for informational purposes only and should not replace professional medical advice. Always consult with a qualified healthcare provider for accurate diagnosis and treatment options specific to your condition.