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Achalasia — causes, side effects and treatments at

Wednesday, December 20, 2017 by

Achalasia is rare motor disorder of the esophagus and lower esophageal sphincter. It is a failure of smooth muscle fibers to relax, which can cause a circular muscle, called a sphincter, to remain closed even when it is needed to open. While achalasia can happen to many parts of the body, achalasia usually refers to the esophagus and is also known as esophageal achalasia, achalasia cardiae, cardiospasm, and esophageal aperistalsis. Achalasia can also happen in the gastrointestinal tract and in the rectum, where sphincters are located. To diagnose, medical experts use esophageal manometry, or the evaluation of the pressure in the esophagus. An x-ray imaging test called a barium swallow can also be used to diagnose esophageal achalasia.

Esophageal achalasia affects one person out of 100,000 annually, without gender predominance. It can be characterized by swallowing difficulties and chest pain. The causes of achalasia are unknown, but some studies are starting to associate it with an autoimmune context which are most likely caused by viral triggers. Other studies associate this disorder with heredity, neurodegenerative, genetic, and infective reasons.

Known side effects of achalasia

Some of the known signs and symptoms of esophageal achalasia include difficulty in swallowing, backflow or regurgitation of undigested food, chest pain behind the sternum, and unintentional weight loss. Some uncommon symptoms include coughing when lying horizontally, and non-cardiac chest pain (which can be mistaken for a heart attack). In some situations, retained food and liquid in the esophagus may be inhaled into the lungs, or aspiration.

Body systems harmed by achalasia

Achalasia is most common in the esophagus, but may also happen in the gastrointestinal tract and rectum, and other body parts that may have a sphincter.

Food items or nutrients that may prevent achalasia

The following food items may help prevent the disorder, but are usually consumed when an individual already has the condition. Some foods that may help ease the symptoms of achalasia include:

  • Soft, liquid food such as porridge, soups, mashed vegetables.
  • Protein-rich food like chicken, fish, soya.
  • High-fiber foods to help detoxify the esophageal and gastrointestinal system.
  • Ginger and dairy products ease the pains of swallowing.

Individuals with achalasia should avoid fried and spicy foods, high carbohydrate foods, citrus fruits, and caffeine.

Treatments, management plans for achalasia

There are many treatments available for esophageal achalasia, but no known medication can cure the condition. Some examples of treatments include:

  • Botulinum toxin – Also known as botox, injection of this toxin helps relax sphincter muscles. However, botox treatment has a short-term effect, and achalasia may reoccur.
  • Long-acting nitrates or calcium channel blockers – These medicines can be used to relax the lower esophageal sphincter (LES). Nitrates or nifedipine makes individuals suffering from esophageal achalasia swallow easier and less painful. However, this method does not work for everyone, and may cause side effects like headaches. Like botox therapy, it also lasts for a short while.
  • Heller’s myotomy – This is a laparoscopic (keyhole) surgical procedure wherein the LES is cut. To date, this procedure can permanently make swallowing easier. Heller’s myotomy may cause acid reflux, chest pain and heartburn, therefore a secondary procedure may be required.
  • Balloon dilation – A procedure done during upper endoscopy (EGD) wherein the part of the narrowed esophagus is widened using a balloon attached to an endoscope. This procedure is done with help of a sedative or general anesthetic. Balloon dilation improves swallowing for most people, but must be done several times before improvement is noticeable. Ballon dilation may cause esophageal rupture, or tearing of the esophagus.

While outcomes of all surgical and non-surgical treatments are the same, some benefits may last longer than others. In rare occasions, more than one treatment is necessary.

Where to learn more


Achalasia, or esophageal achalasia, is a rare disorder wherein the esophagus’ sphincter does not relax.

Esophageal achalasia prevents an individual from swallowing liquids or foods, and may cause serious side effects.

Esophageal achalasia is treatable, but there is currently no permanent, non-invasive solution for it.

Sources include: 1 2


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