Achalasia
Overview
Achalasia is a rare disorder of the food pipe (oesophagus), which can make it difficult to swallow food and drink.
Symptoms
Not everyone with achalasia will have symptoms. But most people with achalasia will find it difficult to swallow food or drink (known asdysphagia). Swallowing tends to get gradually more difficult or painful over a couple of years, to the point where it is sometimes impossible. Other symptoms include: bringing back up undigested foodchoking and coughing fitsheartburnchest painrepeatedchest infectionsdrooling of vomit or salivagradual but significantweight loss Symptoms of achalasia may start at any time of life. Swallowing problems can also be caused by cancers of the mouth, throat and oesophagus. There’s a link between long-term achalasia and the risk of developingcancer of the oesophagus, but the risk is small. It’s always important to get symptoms checked straight away, even if your symptoms are not bothering you.
Causes
Achalasia is thought to happen when the nerves in the oesophagus become damaged and stop working properly, which is why the muscles and ring of muscle do not work. The exact cause of this is unknown. In some people, it may be linked to a viral infection. It may also be associated with having an autoimmune condition, where the body's immune system attacks healthy cells, tissue and organs. In rare cases, it's possible that achalasia is caused by a faulty gene.
Treatment
There is no cure for achalasia, but treatment can help relieve the symptoms and make swallowing easier. Your doctors will talk to you about the risks and benefits of the different treatment options. Medicines, such as nitrates ornifedipine, can help to relax the muscles in your oesophagus. This makes swallowing easier and less painful for some people, although they do not work for everyone. The effect only lasts for a short time, so medicine may be used to ease symptoms while you wait for a more permanent treatment. They may cause headaches, but this usually improves over time. Balloon dilation and surgery can both cause side effects such asacid reflux and heartburnand chest pain. A GP may be able to prescribe medicine to help with this, and your surgeon may suggest you take this medicine routinely. It's normal for chest pain to persist for a while after treatment. You should see a GP if you still have swallowing difficulties or are continuing to lose weight after treatment. Read about living with achalasia on the Achalasia Action website