Esophageal achalasia causes difficulty in swallowing due to a narrow lower esophageal sphincter. Symptoms include food regurgitation, chest pain, weight loss, and fatigue. Treatment includes medication or surgery.
Esophageal achalasia occurs when the lower esophageal sphincter (LES) that normally allows food to pass into the stomach is too narrow. Solid foods and liquids have difficulty passing through the tube, causing significant swallowing difficulties. Other symptoms of esophageal achalasia can vary from person to person, but most patients experience food regurgitation, mild chest pain, and weight loss. People who are able to recognize and explain early symptoms of achalasia of the esophagus to their doctors can help ensure they receive accurate diagnoses and treatment.
The LES normally expands and contracts at a regular rate to help food reach the digestive tract. If the muscles that control the LES are unable to relax, the passage of food is slow, difficult, and sometimes painful. Trouble swallowing even small bites of food or sips of liquids are the most common symptoms of esophageal achalasia. When food sticks to the esophagus, the upper chest and throat feel tight and sometimes painful. Choking can occur with a large bite or when trying to swallow a particularly thick liquid.
Additional symptoms of esophageal achalasia can include regurgitation of food into the mouth, weight loss, and fatigue. Food that does not reach the stomach accumulates in the throat until it is no longer contained. After a medium to large meal, it is normal for a person to vomit. Because it is undigested material, vomit is much drier and harder in texture than typical stomach acid-coated vomit. Symptoms of weight loss, dehydration, and fatigue are results of an inability to get enough food and liquids over a period of time.
When symptoms of esophageal achalasia become chronic, further problems can arise. Inflammation and swelling may develop because undigested materials constantly irritate the lining of the tube. In some cases a very painful ulcer can form which makes eating and drinking practically unbearable.
It’s important to report symptoms to a doctor whenever they become a persistent annoyance. A doctor can take image scans and peer into the esophagus with a camera to confirm achalasia. Specialized muscle relaxants are commonly prescribed to promote better functioning of the LES. If symptoms don’t improve with medication, a doctor may suggest surgery to cut the muscles around the SLE, temporarily paralyze the sphincter, or remove it altogether. Most people who seek treatment are able to find rapid and significant symptom relief.
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