Nerve damage in the esophagus can cause achalasia, when the valve in the lower area of the esophagus that ordinarily relaxes to allow food to pass into the stomach doesn't open when you swallow. Damage to the valve, the lower esophageal sphincter, can also contribute to achalasia.
Although it’s not a common disorder, the Digestive Health Center at Hartford Hospital has expertise in its diagnosis and treatment. Achalasia can make it hard to swallow solid food or drink liquids. It can also result in weight loss.
What is Achalasia?
Achalasia is a disorder where the muscle of the lower esophagus does not completely relax after swallowing, trapping food in the esophagus. Achalasia is often misdiagnosed or goes completely unnoticed because the symptoms, like difficulty swallowing, are very similar to other gastrointestinal conditions.
Esophageal Motility Disorders:
- Achalasia
- EGJ Outflow Obstruction
- DES (Diffuse Esophageal Spasm)
- Jackhammer Esophagus
- Absent Contractility
- IEM (Ineffective Esophageal Motility)
- Fragmented Peristalsis
Esophageal Anatomic Disorders:
Expertise That Makes a Difference
The Digestive Health Center is among the few centers in the United States – and the only one in Connecticut -- to use Peroral Esophageal Myotomy, or POEM, an endoscopic surgical technique developed in Japan to treat Achalasia.
Common Symptoms
You might have Achalasia if you experience:
- Trouble swallowing
- A feeling that food is lodged in your esophagus
- Backflow of food or acid from your stomach into the esophagus. (Regurgitation.)
- Chest pain or discomfort
- Heartburn
- Unexplained weight loss
Screenings & Tests / Treatments
If you have achalasia, your doctor might recommend regular endoscopic screenings to detect possible signs of esophageal cancer.
Barium Swallow: A type of X-Ray that allows the doctor to take a closer look at your pharynx.
Manometry: Test that measures measures the strength and muscle coordination of your esophagus when you swallow.
Upper Endoscopy (EGD): A small telescopic camera is introduced through the mouth and advanced along the esophagus, stomach and first 2 parts of the duodenum (beginning portion of the small intestine). Patients are provided anesthesia so that they sleep through this 10-minute procedure. No special preparation is required but patients must have an empty stomach. This allows evaluation and photographing of the inner structure and appearance of the upper gastrointestinal system. Biopsies can be obtained if needed that can be analyzed for the presence of infections, inflammation, damage related to reflux, or cancerous cells.
Upper GI X-Ray: Combines the us of barium, and a type of X-Ray known as flouroscopy, to create images of the esophogus, small intestine, and stomach.
Botox Injections: Relaxes the sphincter muscles to minimalize discomfort.
Per Oral Esophageal Myotomy (POEM): This endoscopic procedure relaxes esophageal muscles permanently, creating an opening where the esophagus had narrowed.
Balloon Dilation: In this nonsurgical procedure, your doctor places a special balloon through your lower esophageal sphincter and inflates it, expanding the area where food enters the stomach.
Surgical Interventions
Heller Myotomy: A minimally invasive (laparoscopy or robotic) surgical procedure for patients with Achalasia in which the abnormally thick esophageal muscle fibers are cut, allowing food and liquids to pass into the stomach.