Achalasia is a condition in which your esophagus, the tube that connects your throat to your stomach, isn't able to move food into your stomach. Normally, the muscle at the bottom of your esophagus (lower esophageal sphincter) opens and closes to help move food along. Achalasia causes this valve to stay closed, causing food to back up.

The condition mostly affects adults between 25 and 60 years old, but it can affect children.

Cause

The cause of achalasia is unknown. It doesn’t affect a particular sex, race, or ethnicity more than the general population. Researchers believe it could be related to nerve cell problems in the esophagus. People with achalasia have a slightly higher risk of developing esophageal cancer.

Symptoms

Symptoms of achalasia usually develop gradually. The most common symptom is difficulty swallowing (dysphagia), and other symptoms may include:

• Chest pain that comes and goes
• Heartburn
• Nighttime coughing
• Regurgitation of undigested food or liquid (reflux)

At the University of Miami Health System, we use a team approach to find the best treatment for you. Achalasia is often mistaken for gastroesophageal reflux disease (GERD), but our specialists are experienced at discovering and treating the disease. You can be confident you’re working with an experienced team.

Tests

Barium Swallow
Your doctor will have you swallow a liquid dye (barium). They will use an X-ray to watch you swallow the liquid and evaluate the function of your esophagus.

Endoscopy
This imaging test uses a flexible, narrow tube and viewing device (endoscope) guided into your esophagus. This lets your doctor take a closer look at the inside of your esophagus.

Manometry
Manometry is a type of endoscopy that uses pressure sensors to measure your muscle contractions when you swallow.

Endoscopic Functional Luminal Imaging Probe (EndoFLIP®)
This procedure uses a flexible tube with a balloon at the end, which is fitted with sensors. The test measures the distance across your esophagus and the pressure within it. This information tells your doctor about the stiffness of your esophageal muscles.

Treatments

Nonsurgical Treatments
If you’re not a good candidate for surgery, your doctor may use a nonsurgical approach to help improve swallowing. They may prescribe medicine to help relax muscles in your throat, including Botox® injections.

Your doctor may also use balloon dilation to relieve your symptoms. Your doctor guides an uninflated balloon down your throat and through the lower esophageal sphincter and inflates it. This widens the opening to allow food to enter the stomach. You may need to have the procedure a few times to relieve your symptoms.

Minimally Invasive Surgery
Surgeons use an advanced approach that uses small incisions to open up the lower esophageal sphincter (called Heller myotomy or laparoscopic esophagomyotomy). They also tighten your esophageal sphincter by wrapping the top of your stomach around it (called Dor fundoplication) to prevent GERD. Usually, this minimally invasive approach only requires a single night in the hospital and offers a faster recovery than after a traditional, open procedure.

Per Oral Endoscopic Myotomy (POEM)
Your doctor guides a flexible, narrow tube and viewing device (endoscope) down your throat to make small cuts in your esophageal muscles to relax them and widen any narrowing.

Why Choose UHealth?

Fast, accurate diagnosis. We have the only motility lab in South Florida, which allows our GI specialists to provide accurate results faster. That means they can begin treatment right away, and you can feel better sooner.

Expert care for digestive conditions. Our digestive health experts care for a full range of conditions – from an upset stomach to colorectal cancer. As an academic medical center, we offer the latest, proven approaches backed by the leading-edge research of the University of Miami Miller School of Medicine.

A comprehensive team. Digestive health specialists work as a team with dietitians, surgeons, and other specialists to ensure you get complete care. You work with a team that gives you individual attention and treatment that offers you the best possible results.

Leaders in robotic surgery treatment. We have some of the world’s most experienced robotic surgeons for minimally invasive procedures. We were the first academic medical center in the world to get the da Vinci Xi robotic surgery system. Our surgeons have completed more than 5,000 robotic surgeries — procedures that offer less pain and scarring and a faster recovery.