Achalasia

Achalasia is a rare disorder that affects your esophagus, the tube that moves food to your stomach. In this condition, the muscle ring at the bottom of the esophagus fails to relax normally. The esophagus also loses its ability to squeeze food down effectively. As a result, food and liquids can get stuck. Common signs include difficulty swallowing both solids and liquids, regurgitating undigested food, and feeling pressure in your chest. Some people also experience unexplained weight loss because eating becomes difficult. Because these symptoms can mimic other conditions like acid reflux, getting a proper evaluation is important to find the right cause and start the correct treatment plan for your specific needs.

Diagnosing achalasia usually requires several different tests to confirm the condition and rule out other problems. A specialist will often start with an upper endoscopy to look inside your esophagus and a barium swallow to see how food moves. The most important test is called esophageal manometry. During this test, a thin tube measures your muscle contractions and how well the lower muscle ring relaxes. Another helpful tool is the EndoFLIP, which measures how well the connection between your esophagus and stomach stretches. These tests help your doctor understand your specific motility pattern. By combining these results, your care team can confirm the diagnosis and determine which treatment option will be the safest and most effective for your health goals.

While treatments cannot restore lost nerve function, they can help the lower esophageal muscle open so food passes more easily. A specialist might suggest lifestyle changes like taking smaller bites or drinking more water with meals. Medical options include Botox injections for temporary relief or pneumatic dilation to stretch the muscle with a balloon. More definitive treatments include a Heller myotomy, which is a surgical procedure to cut the muscle, or a POEM procedure performed through the mouth. The best choice depends on your age, overall health, and specific test results. A foregut specialist will review your symptoms and test data to help you compare these options, focusing on balancing long term symptom relief with the risk of future acid reflux.

You should seek immediate medical attention if you suddenly cannot swallow or are unable to keep any fluids down. Other urgent warning signs include choking, trouble breathing, or experiencing severe chest pain. You should also contact a doctor right away if you vomit blood, notice black or tarry stools, or develop a fever along with a cough. Rapid and unexplained weight loss is another sign that requires a prompt evaluation. These symptoms could indicate a complete blockage or that food is being inhaled into your lungs. While many people with achalasia adapt to their symptoms over time, these specific signs mean your condition needs fast assessment to prevent serious complications and ensure you receive the necessary support to stay hydrated and nourished.