Achalasia (say "ay-kuh-LAY-zhuh") is a rare problem with the nerves that control the muscles in the esophagus, the tube that carries food and liquid to your stomach. The muscles may tighten or spasm. The muscle that connects the lower end of the esophagus to the stomach may not open and close the right way.
What happens when you have achalasia?
When you have achalasia, you may have trouble swallowing foods and liquids. You may spit up (regurgitate) food. That means undigested food may come back up into your mouth. You may also have heartburn or pain in your chest.
These symptoms may cause you to lose weight. There's also a risk that you could inhale food or liquid into your lungs (aspiration). That may lead to pneumonia.
How is achalasia treated?
Medicines, such as nitroglycerin or calcium channel blockers, can help relax the muscles in your esophagus. But the medicines usually work only for a short time after taking them, making the relief temporary.
Many people have a procedure called esophageal dilation.
During the procedure, you will get medicines through a vein (intravenous, I.V.). These medicines reduce pain and will make you feel relaxed and drowsy. You will also get medicine sprayed on the back of your throat to numb it. You may not remember much about the procedure.
The doctor will guide a balloon or a plastic tool (dilator) down your throat and into your esophagus. Then the dilator is expanded, like a balloon filling with air. It widens any narrow parts of your esophagus.
To guide the dilator, the doctor uses an endoscope, which is a thin, flexible, lighted viewing instrument. It goes into your mouth and down your throat. Or the doctor may use a thin wire to guide the dilator.
Some people have surgery for achalasia. Then you will have general anesthesia so that you are asleep and won't feel pain during the surgery. Surgeries include:
Heller myotomy. In this surgery, the doctor makes small cuts on the muscles inside the esophagus. This allows the opening to the stomach to relax so that food and liquids can pass through. It can be done through a thin, lighted tube (laparoscope) that is placed in a small cut in the belly. Sometimes it's done through a larger cut (incision). You may stay in the hospital for 1 or 2 days after the surgery.
Peroral endoscopic myotomy (POEM). This surgery also involves making small cuts on the muscles. But it's done through an endoscope that goes in through the mouth. You may stay in the hospital for a day after the surgery.
Achalasia may also be treated with a botulinum toxin A (Botox) injection. Botox is injected into the muscle near the opening to the stomach through an endoscope. It helps the muscle relax. You may need more shots of Botox after 6 months or a year.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Clinical Review Board All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Clinical Review Board All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.
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