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Achalasia

What Is Achalasia?

Achalasia is a motility disorder and a rare condition that impacts the entire esophagus. With achalasia, the middle part of the esophagus has difficulty contracting, while the lower muscle of the esophagus cannot relax properly. This makes it hard to swallow and move food down into the stomach. Because achalasia comes on gradually, it can be difficult to diagnose and requires the expertise of specialists with experience in treating this rare condition. While the exact cause is not known, studies suggest achalasia may be related to damage in the nerves of the chest. 

Achalasia Signs and Symptoms

Early signs of achalasia may only include difficulty swallowing and chest pain that may come and go. However, other early symptoms include:

  • A feeling that food is stuck in your throat
  • Coughing during meals
  • Chest pain or discomfort
  • Heartburn

As the disorder progresses you may develop more serious symptoms, including:

  • Intense pain after eating
  • Food regurgitation, where food is pushed back up into your mouth after swallowing
  • Aspiration, which is when food is propelled into your lungs 
  • Significant weight loss from lack of nutrition

In very severe cases, achalasia may lead to lung infections such as pneumonia and death. 

When to Seek a Specialist

If left untreated, achalasia symptoms can become serious, so it’s important to see a specialist as soon as possible. Early diagnosis and advanced treatments can help manage your condition and prevent complications.

Why Temple Health for Achalasia

Because some motility disorders have similar symptoms, achalasia can be difficult to diagnose. As part of Temple’s Digestive Diseases Center, our Motility Disorders Program is led by gastroenterologists who specialize in complex diseases of the esophagus. We have the expertise to provide you with fast, accurate diagnosis and the latest treatments available, as well as clinical trials. Our program features:

  • Physicians who have consistently been named Best Doctors in America® and among Philadelphia magazine’s “Top Doctors.”
  • Experience in discovering and evaluating investigational therapies through our innovative digestive diseases research program.
  • A multidisciplinary team of Motility Disorder Program specialists who collaborate to specifically manage achalasia.

Achalasia Treatment Options

Treatments for achalasia are focused on relaxing the muscle at the end of the esophagus so you can eat normally and have fewer symptoms. Temple’s motility disorders specialists offer the latest technology and advanced treatments to help manage your condition. These include:

Pneumatic Dilation

Pneumatic dilation is a same-day procedure where you are given a sedative or anesthesia and then your doctor uses an endoscope to insert a balloon into your esophagus. The balloon is then inflated, which stretches the lower esophageal sphincter allowing food to pass through to your stomach. This procedure is fast and effective, with minimal recovery time.

Minimally invasive surgeries

Temple offers two types of surgeries to help cut fibers in your lower esophageal sphincter, leading to improved symptoms. These include:

  • POEM procedure: A gastroenterologist inserts an endoscope through the mouth and into the esophagus, then makes a small incision in the esophageal muscles. This weakens the lower esophageal sphincter, making it easier to eat and drink.

  • Heller myotomy: A surgeon makes several small incisions (cuts) in your lower abdomen (belly) and inserts a thin tube into your esophagus. This tube has a camera and light attached, and also allows small instruments to be passed through to allow the surgeon to repair constricted esophageal muscles.

  • Fundoplication: Surgeons often perform this procedure along with Heller myotomy to reduce the risk of developing gastroesophageal reflux disease (GERD). Surgeons fold the top part of your stomach (fundus) then fold it around the valve located at the bottom of your esophagus. This helps tighten the space between your esophagus and stomach to prevent stomach acid from backing up into your esophagus.

These surgeries are minimally invasive and are performed with as few incisions as possible for faster healing and recovery. 

Watch Laura’s Story

For Laura, the simple act of eating was scary. Temple experts recommended the POEM procedure to help clear the passage between her esophagus and her stomach. Now Laura can eat without worry.

Watch Laura's story on 6abc.com

Ready for an Appointment?

To find out if your symptoms are related to achalasia, or for a second opinion, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) with Temple’s Motility Disorders Program experts.

Learn more about our doctors and care team who diagnose and treat achalasia.