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Achalasia: Symptoms, Diagnosis and Treatment

Achalasia is a rare condition that affects the esophagus, the muscular tube that connects the throat to the stomach. It occurs when the lower esophageal sphincter (LES), the muscle that controls the opening between the esophagus and the stomach, fails to relax properly when you swallow. As a result, food and liquid cannot pass easily into your stomach, causing symptoms such as difficulty swallowing, chest pain, and regurgitation. In this article, we will discuss the symptoms, diagnosis, and treatment of achalasia.

Symptoms of Achalasia

The symptoms of achalasia develop gradually over time and can vary from person to person. The most common symptoms include:

• Dysphagia: Difficulty swallowing, especially with solid foods, which may feel like food is stuck in your chest.

• Chest pain: A sensation of pressure or burning in the chest, which can be mistaken for heartburn.

• Regurgitation: The backflow of food or liquid into the throat or mouth.

• Weight loss: Difficulty swallowing may cause you to eat less, leading to unintended weight loss.

• Heartburn: Although rare, some people with achalasia may experience heartburn due to the backup of food and acid in the esophagus.

If you experience any of these symptoms, it is important to see your doctor for an evaluation. Achalasia can be mistaken for other conditions, such as gastroesophageal reflux disease (GERD), so an accurate diagnosis is essential.

Diagnosis of Achalasia

To diagnose achalasia, your doctor will perform a physical exam and ask about your symptoms. They may also recommend one or more of the following tests:

• Barium swallow: You will be asked to drink a liquid containing barium, which shows up on X-rays. This test can help your doctor see how well food and liquid are moving through your esophagus.

• Endoscopy: A thin, flexible tube with a camera on the end is passed down your throat to examine your esophagus. This test can help your doctor rule out other conditions, such as cancer.

• Esophageal manometry: A small tube is passed through your nose and into your esophagus to measure the pressure and coordination of the muscles in your esophagus.

If these tests confirm a diagnosis of achalasia, your doctor may refer you to a specialist, such as a gastroenterologist or surgeon, for further treatment.

Treatment of Achalasia

There is no cure for achalasia, but treatment can help relieve symptoms and improve your quality of life. The goals of treatment are to reduce the pressure in the LES and improve the movement of food and liquid through the esophagus. Treatment options include:

• Balloon dilation: A small balloon is inflated inside the LES to widen the opening and improve swallowing. This procedure is done during an endoscopy.

• Botox injection: Botulinum toxin is injected into the LES to relax the muscle and improve swallowing. This treatment is temporary and may need to be repeated every few months.

• Surgery: If other treatments are not successful, surgery may be recommended to cut the muscle fibers of the LES and allow food and liquid to pass more easily into the stomach.

In conclusion, achalasia is a rare condition that affects the esophagus and causes difficulty swallowing, chest pain, and regurgitation. If you experience any of these symptoms, it is important to see your doctor for an evaluation. With proper diagnosis and treatment, most people with achalasia can manage their symptoms and live a normal life.