Achalasia

Achalasia is a problem with swallowing. It happens when the muscles in the tube that carries food from your mouth to your stomach (the esophagus) don't work properly. This is because of damage to the nerves that control these muscles. This makes it hard for the muscles to squeeze the food down into your stomach. As a result, food gets stuck in the esophagus. Sometimes, the food sits there and ferments, which can make it taste sour or bitter and cause it to come back up into your mouth.

This condition is not very common. It can sometimes be confused with GERD (Gastroesophageal Reflux Disease). The key difference is where the food is coming from. In achalasia, the food is stuck in the esophagus itself. In GERD, the food or acid comes up from the stomach.

Unfortunately, there's no way to completely fix achalasia. Once the nerves and muscles in the esophagus are damaged, they can't go back to working normally. However, there are ways to manage the symptoms and make swallowing easier. Doctors often use a procedure called endoscopy. This involves looking inside the esophagus with a camera to help diagnose the problem and sometimes treat it. Minimally invasive therapies, which use smaller tools and incisions, can also help relax the muscles in the esophagus. Surgery is another option in some cases. These treatments can help relieve the symptoms and improve a person's quality of life.

Achalasia is a condition that often develops slowly, getting progressively harder to manage over time. Common signs include:

• Trouble swallowing (dysphagia): This feels like food or liquid is getting stuck in your throat. It can be a persistent feeling, not just an occasional hiccup. This difficulty can affect both solid foods and liquids.

• Food or saliva coming back up: Instead of going down, swallowed food or saliva may return to your throat, potentially causing discomfort or a feeling of fullness.

• Heartburn: A burning sensation in your chest, similar to heartburn from other causes.

• Burping (belching): Frequent or unusually strong belching can be a sign of the problem.

• Occasional chest pain: This pain may come and go, and isn't always a constant issue.

• Nighttime coughing: A persistent cough, especially at night, could be related to food or acid reflux irritating your airways.

• Lung infection (pneumonia): If food or stomach contents get into your lungs, it can lead to a serious lung infection called pneumonia. This is a more severe symptom and requires medical attention.

• Weight loss: As swallowing becomes more difficult, and as your body struggles to get the nourishment it needs, unintentional weight loss can occur.

• Vomiting: In some cases, food or liquid may come back up as vomit, which can be a sign that the esophagus isn't working properly.

These symptoms can vary in severity from person to person. If you experience any of these, it's important to see a doctor for an accurate diagnosis and appropriate treatment.

Scientists don't fully know what causes achalasia. A common theory is that it happens when nerve cells in the food pipe (esophagus) are damaged or lost. Exactly why these nerve cells are lost is still being studied, but possible explanations include viral infections or the body's immune system attacking healthy tissues (an autoimmune response). In extremely rare cases, achalasia might be linked to a person's genes or a past infection.

Achalasia is a condition that makes it hard for food to pass from the throat to the stomach. Several things can increase the chances of getting this condition.

One factor is age. While anyone can develop achalasia, it's more often seen in people between 25 and 60 years old. This doesn't mean younger or older people can't get it, just that it's more frequently diagnosed in this age range.

Another factor is certain health conditions. People with allergies, a condition called adrenal insufficiency (where the body doesn't produce enough of certain hormones), or a rare genetic disorder called Allgrove syndrome are at a slightly higher risk of developing achalasia. These conditions may somehow affect the muscles in the esophagus (the tube that carries food from your throat to your stomach), making them less likely to work properly. This can lead to the problems associated with achalasia.

Achalasia can be hard to spot because its symptoms are similar to other digestive problems. Doctors use several tests to figure out if you have achalasia.

Esophageal Manometry: This test checks the muscles in your esophagus. It looks at how well these muscles contract when you swallow and how well the lower esophageal sphincter (a ring of muscle at the bottom of the esophagus) opens. This test is very helpful for deciding what kind of swallowing problem you might have.

X-rays of the Upper Digestive System: You'll drink a special chalky liquid (barium). The barium coats the inside of your digestive tract, making it easier for doctors to see your esophagus, stomach, and upper intestines on an X-ray. This helps them see any blockages. Swallowing a barium pill can also help show blockages in the esophagus.

Upper Endoscopy: A thin, flexible tube with a tiny camera at the end is inserted through your mouth and into your esophagus. This lets doctors look directly at the upper digestive system. This helps find blockages in your esophagus. The camera can also take a small tissue sample (biopsy) to check for things like Barrett's esophagus, a complication of acid reflux.

Functional Luminal Imaging Probe (FLIP): This is a newer technique. If other tests aren't enough to confirm a diagnosis of achalasia, FLIP can help.

If you have concerns about achalasia, Mayo Clinic has experts who can provide support and care.