What is Achalasia?

Achalasia is a rare disorder of the esophagus in which the lower esophageal sphincter (LES) fails to relax properly and the muscles of the esophagus lose their ability to move food toward the stomach.

Causes:

• Exact cause is unknown.

• Believed to be related to nerve damage in the esophageal wall.

Symptoms:

• Difficulty swallowing (dysphagia)

• Regurgitation of food

• Chest pain or discomfort

• Weight loss

• Coughing or choking while eating

Diagnosis:

• Esophageal manometry (gold standard)

• Barium swallow X-ray

• Endoscopy

Treatment Options:

Non-surgical:

• Botox injections into the LES (temporary relief)

• Oral nitrates or calcium channel blockers (reduce LES pressure)

Surgical:

1. Heller Myotomy (Laparoscopic or Robotic):

   • Cuts the muscle at the LES to allow food to pass

   • Often combined with anti-reflux surgery (e.g., fundoplication)

2. POEM (Peroral Endoscopic Myotomy):

   • A newer, less invasive endoscopic approach