Achalasia is a rare disorder that makes it difficult for food and liquid to pass into your stomach. Achalasia occurs when the food tube (esophagus) loses the ability to squeeze food down, and the muscular valve between the esophagus and stomach doesn't fully relax. The reason for these problems is damage to the nerves in the esophagus. There's no cure, but achalasia symptoms can usually be managed with minimally invasive (endoscopic) therapy or surgery.

  • Diagnostic expertise. Achalasia can be mistaken for other digestive tract disorders. Mayo Clinic specialists experienced in treating achalasia use state-of-the-art imaging to pinpoint the cause of your problem.
  • Minimally invasive approach. If you need surgery for achalasia, Mayo surgeons typically use laparoscopic techniques, which usually involve less pain and faster recovery than traditional surgery.
  • New ideas. Mayo Clinic researchers are researching new treatments for achalasia. You have access to the expertise of Mayo's clinician-researchers.

Mayo Clinic in Rochester, Minn., ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked high performing for digestive disorders by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Specialists in gastroenterology usually manage care for adults who have achalasia.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in gastroenterology usually manage care for adults who have achalasia.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in gastroenterology usually manage care for adults and children who have achalasia. An esophageal group within gastroenterology specializes in studying and treating complex disorders of the esophagus, including achalasia.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Achalasia can be difficult to diagnose because it has symptoms similar to other digestive disorders. Mayo Clinic has radiologists and esophagus specialists experienced in recognizing achalasia.

Mayo specialists use the latest technology, including:

  • Esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water. High-resolution manometry, used at Mayo Clinic, can assess the severity of your achalasia and guide treatment decisions.

Other useful tests include:

  • Esophagram (barium swallow). An X-ray visualizes movement of liquids through the esophagus when you swallow.
  • Endoscopy. A flexible, narrow tube (endoscope) with a camera is used to view the inside of the esophagus and stomach.

Read more about esophageal manometry and endoscopy.

Achalasia treatment focuses on relaxing or forcing open the valve between the esophagus and stomach (lower esophageal sphincter) so that food and liquid can move more easily through your digestive tract.

Specific treatment depends on your age and the severity of the condition. The options include:

  • Balloon dilation. A balloon is inserted into the esophageal sphincter and inflated to enlarge the opening. This outpatient procedure may need to be repeated if the esophageal sphincter doesn't stay open. Some people can go as long as 10 or 15 years before needing repeat balloon dilation.
  • Surgery. Mayo surgeons use a minimally invasive procedure (laparoscopic Heller myotomy) to cut the muscle at the lower end of the esophageal sphincter. People who have a Heller myotomy may later develop gastroesophageal reflux disease (GERD). To prevent reflux problems, Mayo surgeons sometimes do a second procedure (fundoplication) during the surgery when the esophageal sphincter muscle is cut. Surgery may be the preferred option for younger people, although research shows it can be effective in older people.
  • Botox (botulinum toxin). This muscle relaxant can be injected directly into the esophageal sphincter with an endoscope. Studies indicate that the injections may need to be repeated, and they may make it more difficult to perform surgery later if needed. Mayo specialists usually use Botox only for older adults and those who aren't good candidates for surgery.

Mayo Clinic researchers are working to develop improved treatment for achalasia, including an endoscopic method of myotomy (POEM procedure), as well as studying the long-term effectiveness of achalasia therapies. Mayo scientists are also researching the causes of the nerve damage that leads to achalasia.

Publications

See a list of publications by Mayo Clinic doctors on achalasia on PubMed, a service of the National Library of Medicine.

Nov. 16, 2012