Experiences with

Achalasia

Achalasia is a rare disorder of the food pipe (oesophagus), which can make it difficult to swallow food and drink.

Normally, the muscles of the oesophagus contract to squeeze food along towards the stomach. A ring of muscle at the end of the food pipe then relaxes to let food into the stomach.

In achalasia, the muscles in the oesophagus do not contact correctly and the ring of muscle can fail to open properly, or does not open at all. Food and drink cannot pass into the stomach and becomes stuck. It is often brought back up.

Symptoms of achalasia

Not everyone with achalasia will have symptoms.

But most people with achalasia will find it difficult to swallow food or drink (known as dysphagia). Swallowing tends to get gradually more difficult or painful over a couple of years, to the point where it is sometimes impossible.

Other symptoms include:

Symptoms of achalasia may start at any time of life.

Long-term achalasia increases the risk of developing cancer of the oesophagus. This means it's important to get appropriate treatment straight away, even if your symptoms are not bothering you.

Causes of achalasia

Achalasia is thought to happen when the nerves in the oesophagus become damaged and stop working properly, which is why the muscles and ring of muscle do not work. The exact cause of this is unknown.

In some people, it may be linked to a viral infection. It may also be associated with having an autoimmune condition, where the body's immune system attacks healthy cells, tissue and organs.

In rare cases, achalasia may run in families.

Diagnosing achalasia

If a GP thinks you have achalasia, you'll be referred to hospital to have some diagnostic tests. Achalasia may also be diagnosed during an investigation, such as a chest X-ray, for another reason.

The tests for achalasia include:

  • Manometry – a small plastic tube is passed through your mouth or nose into your oesophagus to measure the muscle pressure along it at different points.
  • Barium swallow – you drink a white liquid containing the chemical barium and X-rays are taken. The barium shows up clearly on X-ray so the doctor can see how long it takes to move into your stomach.
  • Endoscopy – a thin, flexible instrument called an endoscope is passed down your throat to allow the doctor to look directly at the lining of your oesophagus, the ring of muscle and your stomach.

Treatments for achalasia

There is no cure for achalasia, but treatment can help relieve the symptoms and make swallowing easier.

Your doctors will talk to you about the risks and benefits of the different treatment options.

Medicine

Medicines, such as nitrates or nifedipine, can help to relax the muscles in your oesophagus. This makes swallowing easier and less painful for some people, although they do not work for everyone.

The effect only lasts for a short time, so medicine may be used to ease symptoms while you wait for a more permanent treatment. They may cause headaches, but this usually improves over time.

Stretching the muscle (balloon dilation)

Under a sedative or general anaesthetic, a balloon is passed into the oesophagus using a long, thin flexible tube (endoscope). The balloon is then inflated to help stretch the ring of muscle that lets food into your stomach.

This improves swallowing for most people, but you may need treatment several times before your symptoms improve.

Balloon dilatation does carry a small risk of tearing the oesophagus (oesophageal rupture), which may require emergency surgery.

Botox injection

Using an endoscope, botox is injected into the ring of muscle that lets food into your stomach, causing it to relax.

It is usually effective for a few months and occasionally for a few years, but it has to be repeated. This is usually painless, and can be used for temporary relief in people who are not able to have other treatments.

Surgery

Under general anaesthetic, the muscle fibres in the ring of muscle that lets food into your stomach are cut. This is done using keyhole surgery (laparoscopy) and is called Heller's Myotomy.

It can permanently make swallowing easier.

Often a second procedure will be done at the same time to stop you getting acid reflux and heartburn, which can be a side effect of the Heller's Myotomy operation. Your surgeon will talk to you about this.

In rare cases some people may need an operation to remove part of their oesophagus.

Follow-up treatment

Balloon dilation and surgery can both cause side effects such as acid reflux and heartburn and chest pain. A GP may be able to prescribe medicine to help with this, and your surgeon may suggest you take this medicine routinely.

It's normal for chest pain to persist for a while after treatment. Drinking cold water may help relieve this.

You should see a GP if you still have swallowing difficulties or are continuing to lose weight after treatment.

HealthUnlocked contains information from NHS Digital, licensed under the current version of the Open Government Licence

121 public posts

Pain Relief and Other Issues

More discussion about the different types of achalasia, and details of the Chicago classification system where the details of pressure exerted by the muscles determine the achalasia type in order to try and standardise how the medical profession deals with achalasia types.
Alan_MAdministrator
in Achalasia Action

Aspiration

I have achalasia with a failing esophagus. I have been having trouble with waking and aspirating before I get up. Do you have any recommendations? I do have bed risers inclining my bed.
in Oesophageal Patients Association

Season's Greetings!

We are due to celebrate our first year of existence as a registered charity in January and aim to continue advancing our help and support to those with achalasia in any way we can. www.achalasia-action.org
Alan_MAdministrator
in Achalasia Action
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(Relatively) New achalasia diagnosis

Hi, I was diagnosed with achalasia just before the lockdown-I have Type 2 achalasia. My symptoms seemed to rapidly worsen since diagnosis and as surgery is not an option currently with the coronavirus situation, I had balloon dilation under radiological guidance.
in Achalasia Action

Types of Achalasia

At our meeting on 21 July a question was asked about the different types of achalasia.
Alan_MAdministrator
in Achalasia Action

Recommended Achalasia surgeons for myotomy, urgent as deteriorating condition

I’m willing to travel and pay privately but wondered if anyone knows of a surgeon experienced in myotomy for Achalasia nearer to Leeds who may be restarting surgery soon. Thank you. Steve.
in Achalasia Action

Achalasia bodybuilding

good day Is body building and protein shakes good for achalasia patients ???
in Oesophageal Patients Association

Coronavirus

In many ways anybody with achalasia simply has to follow that advice, and we recommend that you do so.
Alan_MAdministrator
in Achalasia Action

Dysautonomia help my autonomous nervous system is rogue

I’m prescribed methadone for the pain after having no choice but to abuse OxyContin and Percocet to function and of course now I’ve also been diagnosed with gastroparesis and achalasia,trouble swallowing and I get the cause is the methadone.
in Pain Concern

South West Meeting

People with achalasia can experience a very wide range of symptoms. We are not all the same as each other.
Alan_MAdministrator
in Achalasia Action

Anxiety

research And found out that it was causing me to have all those symptoms like anxiety and depression this elements goes under diagnose a lot but to make things short I start getting b12 shots which helps but some times my symptoms return I had suicidal thought but never acted on them I'm now experiencing achalasia
in Anxiety and Depression Support

Achalasia and Food Issues

At our meeting on 3 March 2020 we were pleased to hear the advice given by Claire Donnelly, a specialist dietitian on a number of issues concerning food, nutrition, supplements and a number of other things. You can see a record the meeting on our website https://www.achalasia-action.org/ewExternalFiles
Alan_MAdministrator
in Achalasia Action

Food and Nutrition

But we would also like to know: a) what food or drink causes you most trouble with achalasia, and why? b) what food and drink seems to be easiest with achalasia, and why? c) any tips and information you may have that others may find helpful?
Alan_MAdministrator
in Achalasia Action

Problems trying to come off Lansoprazole capsules

After no improvement I asked to be referred to a gastroenterologist who, after many tests, diagnosed Achalasia as the problem. But I was never told to stop taking the Lansoprazole. The Achalasia was very mild to begin with but is now rapidly deteriorating and I do need surgery.
in Oesophageal Patients Association

Help please

Hi everyone....l m an achalasia patient, diagnosed last Feb (2019). I wanna know experiences of other sufferers of the same condition, how they are coping and any advice they can offer.
in Oesophageal Patients Association

Achalasia/Helminths

Just recently diagnosed with achalasia and awaiting treatment if any. Does anyone have any advise on this. Also has anyone tried Helminths and if so which practitioner would you recommend and what has been your experience. Thank you
in LUPUS UK

Introduction - Achalasia as a teenager

If you're interested in the experience of Achalasia as a teenager, feel free to ask me any questions about it!
in Achalasia Action

Heart Valves for Achalasia?

For achalasia it might need to be an extended (cylindrically) ring with a single flap (as opposed to the twin type used in hearts), but it does appear interesting! Maybe we can insight some medical input going forward.... Thoughts? Neil (ACAC)
neil-acacAdministrator
in Achalasia Action

Showing symptoms of achalasia/ barrets, have been to multiple doctors and have had no tests as they keep blaming pollution/ allergies.

From reading first hand accounts of achalasia, I can confirm I have had every symptom apart from weight loss and that is because I can still eat food at the moment, as long as it is small frequent meals that are easy to digest.
in Oesophageal Patients Association

POEM?

There is a more detailed description of the procedures in 'A Patient's Guide to Achalasia' that you can download from www.achalasia-action.org
Alan_MAdministrator
in Achalasia Action
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