Achalasia

Because the cause of achalasia is not known, the condition is not preventable. Early treatment, however, can lessen the chance of complications.

Consistent difficulty in swallowing both solid food and liquids is the most common symptom of achalasia.

Chest pain, which can mimic heart pain or be felt in the back, neck and arms and which may increase after eating is also a symptom.

Regurgitation of food that is trapped in the esophagus can occur especially in patients with a dilated esophagus.

Heartburn, cough and unintentional weight loss are also symptoms of achalasia.

If you are experiencing any of these symptoms and think you may have achalasia, be sure to see your primary physician or gastroenterologist for a complete diagnosis.

Medication
Medication that helps the LES relax can sometimes be used to treat achalasia, particularly early in the disease. However, most patients do not have a reduction in symptoms with medication, and those who do usually find that relief is only short-term.

Botulinum toxin
An injection of botulinum toxin that weakens the LES is a quick, nonsurgical treatment for achalasia, but the results are often only temporary. The treatment is performed using a lighted, flexible tube inserted through the mouth called an endoscope and can be a good option for elderly patients or those for whom surgery is high risk.

Surgery
Surgery for the treatment of achalasia, called an esophagomyotomy, can often be done laparoscopically. Laparoscopic surgery involves a number of small incisions made in the upper abdomen, into which the surgeon inserts a long, thin camera and surgical instruments. Because of excellent results, a short hospital stay, and a fast recovery time, many surgeons consider laparoscopic surgery to be the preferred approach.

During the esophagomyotomy, while the patient is under general anesthesia, the LES is cut, allowing it to open more easily. The procedure is more reliable and has a higher success rate than dilation and results in a greater reduction in pressure.

Reflux of acid into the esophagus (gastroesophageal reflux disease or GERD) is a possible side effect of surgery. Modification of the procedure so that the LES isn't completely cut can prevent this, or the esophagomyotomy can be combined with anti-reflux surgery (fundoplication).