Achalasia Disease


Achalasia disease is a swallowing disorder that disrupts the functions of the esophagus. All swallowed liquid and solid food travels down the tube-shaped esophagus. In this disease, the esophagus cannot push the food towards the stomach due to the problem in the valve at the lower end of the esophagus. Since the valve muscles cannot expand enough, they cannot allow the passage of food.

What causes achalasia disease?

Loss of nerve cells that control the swallowing muscles in the esophagus causes achalasia disease. The reason for the disappearance of these cells could not be determined. In some cases, this loss is due to a tumor.

Achalasia disease can be seen in people of all ages, regardless of gender. However, the incidence is higher between the ages of 30 and 60. The exact cause is unknown, but some factors increase the risk.

Viral infections such as herpes virus

The immune system's attack on nerve cells

Chagas disease seen in Central and South America

Symptoms of achalasia disease

Symptoms usually appear gradually. The most common symptom is difficulty swallowing solid and liquid foods. Food may accumulate in the esophagus and come back to the mouth. In this case, there is a risk of suffocation. During the achalasia disease;

  • Throat fullness
  • Continuous burping
  • Pain in the chest area
  • Unexplained weight loss
  • Sharp cough after meals
  • Burning and heartburn in the stomach
  • Pneumonia and bronchitis as a result of food getting into the lungs


Diagnosis and treatment of achalasia disease

Doctors consider the possibility of achalasia disease when they complain of difficulty in swallowing. There are generally three methods for diagnosis.

  1. Pressure in the esophagus is measured with manometry.
  2. The esophagus is examined in detail with the imaging method called gastroscopy. A micro camera image is taken, which is placed in a special tube that is lowered from the mouth into the esophagus.
  3. In the barium radiography method, a liquid containing barium is given to the patient. The movement of barium towards the stomach is monitored. If a small amount of the given barium passes into the stomach, the diagnosis is confirmed. This method cannot be applied to pregnant women.


Treatment options vary

  1. Achalasia disease patients with mild symptoms are treated with medication. Medications taken before meals lower the pressure in the esophagus. But due to side effects, the drug can not be used for a long time.
  1. Contraction of the esophagus can be prevented by applying Botox to the valve opening to the stomach. Botox provides 6 to 12 months of relief in achalasia disease. It is applied with gastroscopy. Application should be repeated after the effect wears off.
  1. In balloon dilatation, balloons are placed in the lower part of the esophagus and inflated. This treatment regulates the passage of food into the stomach. It is successful at a rate of 70-80%. This practical method is applied with outpatient treatment in achalasia disease. When it is not effective, surgical treatment is necessary for resolution.
  1. Surgery is the last resort in the treatment of achalasia disease. It is intervened with a surgical technique called “heller myotomy”. This operation, which can be applied open or closed, usually provides a definitive solution. Almost all patients recover completely in the first year. Continuous drug use may be required as surgery may trigger reflux.