Achalasia

Achalasia is a rare, chronic disorder that affects esophageal muscles, making it difficult for patients to swallow food or liquids. In those who suffer from achalasia, the lower esophageal sphincter (LES) -- a ring of muscle that controls the movement of food into the stomach -- fails to relax properly during swallowing, leading to difficulty in moving food down into the stomach. The condition can cause regurgitation of liquids and food you're trying to swallow, as well as other issues.

Achalasia is diagnosed in about 1 in 100,000 people in the U.S. per year. While achalasia can affect people of all ages, it is most commonly diagnosed in adults aged 25 to 60. Those with achalasia may be more prone to pneumonia and lung infections and also have an increased risk of esophageal cancer.

While the exact cause of  achalasia is unknown, one theory is that it may be due to autoimmune disorders that attack the nerves that control the esophagus and LES, leading to the muscle’s inability to fully relax.

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Why Hoag for Achalasia Evaluation and Treatment?

Diagnosed with a rare digestive condition, or have symptoms your doctor is having trouble diagnosing? Trust Hoag to help you find answers and heal. 

As Orange County's leading treatment center for gastrointestinal disorders, the world-class team at the Hoag Digestive Health Institute has seen it all and has the experience to diagnose and treat even rare and poorly understood disorders like achalasia.

Hoag's comprehensive, fully integrated Foregut Program is the best in the area for treating serious or recurring conditions of the esophagus and stomach. Our program offers a patient-centered approach, drawing on the latest advancements in techniques and technology to help patients find answers other programs might miss. The result: better outcomes, fuller recoveries, and solid answers to the questions you need answered now.  Need treatment for achalasia in Orange County? Hoag is here for you every step of the way.  

Symptoms and Causes of Achalasia 

The symptoms of achalasia can vary from patient to patient and in severity. The symptoms of achalasia can be mistaken for those of other conditions, including gastroesophageal reflux disease (GERD), making  the condition difficult to diagnose. 

Symptoms of achalasia may include:

• Difficulty swallowing food or liquids (dysphagia), which is the most common early symptom of the disease

• Regurgitation of food and liquids

• Recurring chest pain that may be severe

• A recurring cough at night

• Recurring heartburn

• Unintended weight loss

Causes and Risk Factors for Achalasia

The exact cause of achalasia is unknown, but factors that are theorized to contribute to the development of the condition include:

• Certain genetic conditions

• Certain autoimmune diseases

• Viral infections

• Abnormal development of the esophagus

Diagnosis and Tests for Achalasia 

To diagnose achalasia, a doctor will perform a physical exam and review the patient’s medical history. Depending on the results of the physical exam, your doctor may also recommend other diagnostic tests. These may include:

• Esophageal manometry, which is a test that measures how strong and how quickly your lower esophageal sphincter (LES) contracts and relaxes. 

• Barium swallow test, which is a test in which the patient drinks a liquid containing barium, which highlights the esophagus on X-rays and can help doctors see any abnormalities

• Upper endoscopy, which is a procedure in which a thin, flexible tube with a camera and a light at the tip is inserted through the mouth and down into the esophagus, allowing doctors to directly view the inside of the esophagus and associated tissues. Explore Hoag's Orange County endoscopy centers located near you.

Advanced diagnosis of conditions of the esophagus and stomach at Hoag

As Orange County's recognized leader in the accurate diagnosis and treatment of conditions involving the stomach and esophagus, the Hoag Digestive Health Institute is here for those facing serious conditions involving these crucial digestive organs, including GERD, Barrett's esophagus, and esophageal cancer. 

At Hoag, advanced procedures used to diagnose or treat conditions involving the stomach and esophagus include: 

• Abdominal ultrasound

• Barium swallow X-ray

• Capsule studies

• Esophageal Bravo pH monitoring

• Esophagogastroduodenoscopy (EGD)

• Endoscopic ultrasound (EUS)

• Esophageal manometry (EM)

• Gastric emptying test (GET)

• Video esophagram

Management and Treatment for Achalasia 

The management of achalasia depends on the severity of the condition, your overall health, and other factors. While there is no cure for achalasia, the condition can often be managed effectively with treatment. Treatment options may include:

• Peroral endoscopic myotomy (POEM), an advanced, minimally invasive surgical technique offered at Hoag, involves cutting the muscles around the lower esophageal sphincter to allow food to pass through more easily

• Heller Myotomy:  A minimally invasive surgical procedure in which muscles of the lower esophageal sphincter and upper stomach are cut to widen the passage between the esophagus and stomach. While POEM is performed by passing a long, flexible instrument called an endoscope through the mouth and into the esophagus, Heller myotomy is accomplished through small incisions in the torso.

• Medications to relax the esophageal muscles

• Botulinum toxin injections to temporarily relax the lower esophageal sphincter

• Balloon dilation to stretch the lower esophageal sphincter

Prevention of Achalasia 

Since the exact cause of achalasia is unknown, there are no specific ways to prevent the condition. However, maintaining a healthy lifestyle, avoiding smoking and alcohol, and eating a balanced diet can help reduce the risk of complications associated with achalasia.