Digestive tractMotility disorderICD-10 K22.0
Achalasia
The nerves of the oesophagus degenerate, so the lower sphincter fails to relax and the oesophagus cannot push food down. Swallowing becomes progressively difficult.
Condition-specific references are below. Individual claims and this page have not been clinically reviewed. Read about this content.
Causes
- Loss of inhibitory nerve cells in the oesophageal wall (probably autoimmune); Chagas disease in South America
Risk factors
- Age 30–60
Symptoms
- Difficulty swallowing solids and liquids
- Regurgitation of undigested food
- Chest pain
- Weight loss
- Night-time cough
Diagnosis — tests and examinations
- High-resolution oesophageal manometry
- Barium swallow (bird's-beak appearance)
- Endoscopy to exclude cancer
Treatment
Medicines and medical treatment
- Botulinum toxin injection for frail patients
Operations and procedures
- Pneumatic balloon dilatation
- Laparoscopic Heller myotomy
- Peroral endoscopic myotomy (POEM)
Self-care, home remedies and lifestyle
- Eat slowly, sit upright after meals
Possible complications
- Aspiration pneumonia
- Malnutrition
- Slightly increased oesophageal cancer risk
Prevention
- None known
Outlook
Treatment relieves symptoms in most patients.
When to see a doctor
See a doctor for any progressive difficulty swallowing.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
Educational overview, not medical advice. Treatment varies by person and location. Consult a qualified health professional for diagnosis or care. Read our content and model notes and privacy information.