Swallowing Disorder and Disease of the Esophagus
Achalasia is a rare disease of the esophagus that causes a person to lose the normal ability to swallow food. The name means a failure to relax and refers specifically to the lower esophageal sphincter muscle (where the lower esophagus meets the stomach).
Unfortunately, achalasia can easily be confused with other conditions; therefore, if you notice a persistent and consistent inability to swallow food or liquid and/or feeling as if food is sticking in the chest, you should consult a doctor immediately. Loss of appetite, vomiting, chest pain and weight loss are also common warning signs. In severe cases of untreated achalasia, aspiration pneumonia (a potentially life-threatening inflammation of the lungs) can occur.
Early diagnosis and treatment are essential to prevent damage to the esophagus and improve function. The key to properly diagnosing achalasia is understanding a person's medical history. It is helpful for the patient to keep a detailed record of when there is difficulty swallowing food, what kinds of foods cause difficulty and any other symptoms, and present this to the doctor.
After an initial exam, the doctor may obtain a barium study (a video x-ray of the upper digestive system) to look for classic signs of achalasia and/or structural problems within the esophagus. Another test is an esophageal manometry (or a pressure test), which uses a thin tube passed through the nose to measure whether the muscles are functioning properly.
Endoscopy is one of the best ways to diagnose achalasia. It is a quick and painless procedure that takes as little as 15 minutes to perform. A gastroenterologist places a small, thin scope with a camera and light into the mouth and passes it down the esophagus to evaluate the condition of the esophageal muscles. From the images taken with the camera, the doctor can determine whether symptoms are caused by achalasia, or by other diseases that can mimic the signs of achalasia.
Treatment options range from oral or injected medications, physical stimulation and stretching of the esophagus, to surgery. Each procedure has differing advantages and disadvantages, but all are designed to relieve the pressure within the lower esophageal sphincter muscle allowing food to pass into the stomach.
If the condition is serious, surgery may be the best option. Surgeons at NYPBMH may perform an esophagomyotomy (or surgical incision into the muscular tissue of the esophagus). A Heller Myotomy is one type of surgery that is performed laparoscopically (using small or keyhole incisions in the abdomen). This type of minimally invasive procedure offers a quicker recovery rate and less risk of post-surgical complications. After surgery, doctors may also recommend medications to help prevent the occurrence of acid reflux or other problems.
Our team of physicians and surgeons work with every patient to provide the best and safest treatment option and plan of care.