From
EUPSA/ERNICA
What is Esophageal Achalasia? An ERNICA animation for patients, parents and families
Part of
Gastroesophageal Reflux 5 items
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Esophageal achalasia is a rare disorder of the esophagus.
Normal esophageal motility is called peristalsis.
The cardia is a muscular valve that relaxes and opens when swallowed food reaches it, then closes to prevent stomach contents from flowing back upwards.
In esophageal achalasia, peristalsis of the esophagus is progressively lost.
In esophageal achalasia, the muscular valve does not relax properly, and food builds up in the esophagus and passes into the stomach with difficulty.
The esophagus may enlarge over time in esophageal achalasia.
Esophageal achalasia can affect people of all ages and is most commonly seen in young adults, but can also affect older adults, teenagers, and very rarely children.
The cause of esophageal achalasia is unknown.
Individuals with achalasia present with difficulties swallowing food and liquid.
Food and saliva built up in the esophagus often travels back to the mouth in achalasia.
Sometimes during breathing, saliva and/or food can enter the lungs, which is called aspiration.
Some affected individuals occasionally experience pain in their chest, back and shoulders, and/or in their neck and lower jaw.
Symptoms of achalasia often occur on an irregular basis to begin with, then eventually become more common.
Progressive symptoms of achalasia often lead to weight loss or, in children, impaired growth.
Repeated unexplained lung infections can occur in achalasia.
A diagnosis of esophageal achalasia is often suspected using a barium swallow X-ray, where the liquid is observed building up in the esophagus and sometimes the esophagus is larger than normal.
Other causes of swallowing difficulties need to be excluded by performing an endoscopy with tissue biopsies.
A manometry test needs to be performed to confirm a diagnosis of esophageal achalasia, measuring the muscle coordination of the esophagus and the relaxation abilities of the muscular valve.
The risk of gastroesophageal reflux differs per treatment for achalasia, and it is necessary to discuss both the advantages and disadvantages with the clinical team.
Structured regular follow-up care is essential for individuals with esophageal achalasia and should be provided by specialist clinicians.
Follow-up endoscopies should be included as part of care for achalasia.
Identifying any complications or difficulties early is very important in achalasia management.
Peer support can be accessed through patient and family support groups for achalasia.
Individuals with esophageal achalasia should be treated at a specialist center by a dedicated team of different professionals.
The treatment of achalasia is focused on disrupting the muscular valve's abnormal persistence to stay tight, so that food can more freely pass into the stomach.
Treatment can be done by making a cut through the valve (myotomy), which can be achieved via a surgical procedure or via endoscopy.
Alternatively, the valve can be stretched using a balloon, which is called pneumatic dilation.
Treatment options for achalasia should be discussed with the clinical team and the patient's individual circumstances should be considered.
Gastroesophageal reflux is when food and acid from the stomach flows back into the esophagus.