Achalasia is a rare disorder that affects the esophagus, the tube that carries food and liquid from the mouth to the stomach. It occurs when the nerves and muscles in the lower part of the esophagus do not work properly, leading to difficulty in swallowing (dysphagia) and incomplete relaxation of the lower esophageal sphincter (LES), the muscle that normally allows food and liquid to pass into the stomach.

Why Does Achalasia Happen?

The exact cause of Achalasia is not fully understood, but it is believed to involve a combination of genetic and autoimmune factors. In Achalasia:

• The nerves in the esophagus that control the muscles become damaged or fail to work properly, causing the LES to remain contracted.
• Immune system involvement is suspected as some research indicates that the body’s immune system may attack the nerve cells in the esophagus.

When Does Achalasia Occur?

Achalasia can occur at any age, but it is most commonly diagnosed between the ages of 25 and 60. It is slightly more prevalent in men than in women.

How to Treat Achalasia

Treatment aims to relieve symptoms and improve the passage of food and liquids through the esophagus. Options include:

Managing stress and avoiding food that can exacerbate symptoms (e.g., spicy foods, alcohol).

Medications:

• Calcium channel blockers (e.g., nifedipine) or nitrates can help relax the LES by reducing pressure.

Non-invasive procedures:

• Pneumatic dilation: A balloon is used to stretch the LES and relieve its pressure.
• Botulinum toxin injections: Temporarily paralyzes the muscles at the junction of the esophagus and stomach.

Surgical procedures:

• Heller myotomy: A surgical procedure that cuts the muscle of the LES to relieve its tightness.
• Laparoscopic or robotic myotomy: Minimally invasive techniques that involve smaller incisions and may offer a quicker recovery.

Lifestyle adjustments:

• Eating smaller, more frequent meals.
• Avoiding lying down immediately after eating.

Other Resources:

• https://www.webmd.com/digestive-disorders/achalasia-what-to-know
• https://pubmed.ncbi.nlm.nih.gov/35513420/
• https://www.healthline.com/health/achalasia
• https://en.wikipedia.org/wiki/Esophageal_achalasia