Overview

Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach.

Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach.

There's no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery.

Symptoms

Achalasia symptoms generally appear gradually and worsen over time. Signs and symptoms may include:

  • Inability to swallow (dysphagia), which may feel like food or drink is stuck in your throat
  • Regurgitating food or saliva
  • Heartburn
  • Belching
  • Chest pain that comes and goes
  • Coughing at night
  • Pneumonia (from aspiration of food into the lungs)
  • Weight loss
  • Vomiting

Causes

The exact cause of achalasia is poorly understood. Researchers suspect it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses have been suspected. Very rarely, achalasia may be caused by an inherited genetic disorder or infection.

Achalasia care at Mayo Clinic

Oct. 21, 2020
  1. Zaninotto G, et al. The 2018 ISDE achalasia guidelines. Diseases of the Esophagus. 2018; doi:10.1093/dote/doy071.
  2. Achalasia. National Organization for Rare Disorders. https://rarediseases.org/rare-diseases/achalasia/. Accessed April 6, 2020.
  3. Achalasia. Canadian Society of Intestinal Research. https://badgut.org/information-centre/a-z-digestive-topics/achalasia/. Accessed April 6, 2020.
  4. Swanstrom LL. Achalasia: Treatment, current status and future advances. Korean Journal of Internal Medicine. 2019; doi:10.3904/kjim.2018.439.
  5. Jung HK, et al. 2019 Seoul consensus on esophageal achalasia guidelines. Neurogastroenterology and Motility. 2020; doi:10.5056/jnm20014.
  6. Achalasia. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/achalasia. Accessed April 6, 2020.
  7. Ahmed Y, et al. Peroral endoscopic myotomy (POEM) for achalasia. Journal of Thoracic Disease. 2019; doi:10.21037/jtd.2019.07.84.
  8. Brown AY. Allscripts EPSi. Mayo Clinic. March 12, 2020.
  9. Blackmon SH (expert opinion). Mayo Clinic. April 8, 2020

Related

Products & Services