Скачать или смотреть What is Achalasia? Explained by a PA!

*Achalasia* is a *rare esophageal motility disorder* where the esophagus has trouble moving food into the stomach.

What goes wrong?

Two main problems occur:

1. *The lower esophageal sphincter (LES) doesn’t relax properly* when you swallow
2. *The esophagus loses normal peristalsis* (the wave-like muscle contractions that push food down)

As a result, food and liquid get *stuck in the esophagus* instead of entering the stomach.

Common symptoms

Difficulty swallowing (**dysphagia**) for both *solids and liquids*
Regurgitation of undigested food
Chest pain or pressure
Heartburn-like symptoms
Weight loss
Nighttime coughing or aspiration

What causes achalasia?

Damage to the *nerve cells (myenteric plexus)* that control esophageal movement
Exact cause is often *unknown (idiopathic)*
Rarely associated with infections, autoimmune disease, or *Chagas disease*

How is it diagnosed?

*Esophageal manometry* (gold standard)
*Barium swallow* showing a “**bird’s beak**” narrowing
*Upper endoscopy* to rule out cancer or strictures

Treatment options

There is no cure, but treatments focus on *relieving obstruction* at the LES:

*Pneumatic dilation*
*Heller myotomy* (surgical)
*POEM* (peroral endoscopic myotomy)
*Botulinum toxin injections* (temporary relief)
Medications (limited benefit)

Key takeaway

Achalasia causes *progressive difficulty swallowing both solids and liquids* due to a **non-relaxing LES and loss of peristalsis**.