From
EUPSA/ERNICA
What is Esophageal Achalasia? An ERNICA animation for patients, parents and families
Part of
Gastroesophageal Reflux 4 items
Chapter 1 of 5 · Fundamentals
Normal anatomy
Normal esophageal anatomy and physiology
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
What is Gastroschisis? An ERNICA animation for parents and families
2 min · Published Dec 2023
Video
What is Omphalocele? An ERNICA animation for parents and families
3 min · Published Dec 2023
Video
What is Congenital Diaphragmatic Hernia (CDH)? An ERNICA animation for parents and families
3 min · Published Dec 2023
Video
What is small bowel atresia?: An ERNICA animation for parents and families
4 min · Published Dec 2023
Video
Hirschsprung-associated enterocolitis in children: An ERNICA animation for parents and families
3 min · Published Dec 2023
Video
Surgical treatment for Hirschsprung’s Disease: An ERNICA animation for parents and families
3 min · Published Dec 2023
What the experts said
Esophageal achalasia is a rare disorder of the esophagus.
Normal esophageal peristalsis moves food through the esophagus into the stomach.
The cardia is a muscular valve that relaxes and opens when swallowed food reaches it, then closes to prevent gastric contents from flowing back upwards.
In esophageal achalasia, peristalsis of the esophagus is progressively lost.
In esophageal achalasia, the muscular valve (cardia) does not relax properly, and food builds up in the esophagus and passes into the stomach with difficulty.
The esophagus may enlarge over time in esophageal achalasia.
Esophageal achalasia can affect people of all ages, is most commonly seen in young adults, but can also affect older adults, teenagers, and very rarely children.
The cause of esophageal achalasia is unknown.
Individuals with achalasia present with difficulties swallowing food and liquid.
Food and saliva built up in the esophagus often travel back to the mouth in achalasia.
During breathing, saliva and/or food can enter the lungs (aspiration) in achalasia.
Some individuals with achalasia occasionally experience pain in their chest, back, shoulders, neck, and lower jaw.
Symptoms of achalasia often occur on an irregular basis initially, then become more common, leading to weight loss or impaired growth in children.
Repeated unexplained lung infections can occur in achalasia.
A diagnosis of esophageal achalasia is often suspected using a barium swallow X-ray, where the contrast liquid is observed building up in the esophagus.
On barium swallow X-ray, the esophagus is sometimes larger than normal in achalasia.
Other causes of swallowing difficulties need to be excluded by performing an endoscopy with tissue biopsies.
A manometry test, which measures muscle coordination of the esophagus and relaxation abilities of the muscular valve, is needed to confirm a diagnosis of esophageal achalasia.
Individuals with esophageal achalasia should be treated at a specialist center by a dedicated multidisciplinary team.
Treatment of achalasia is focused on disrupting the muscular valve's abnormal persistence to stay tight, so that food can more freely pass into the stomach.
Treatment can be done by making a cut through the valve (myotomy), achieved via surgical procedure or endoscopy.
Alternatively, the valve can be stretched using a balloon (pneumatic dilation).
Treatment options for achalasia should be discussed with the clinical team and the patient's individual circumstances should be considered.
The risk of gastroesophageal reflux differs per treatment for achalasia, and it is necessary to discuss both advantages and disadvantages with the clinical team.
Structured regular follow-up care is essential for individuals with esophageal achalasia and should be provided by specialist clinicians.
Follow-up endoscopies should be included as part of care for achalasia.
Identifying any complications or difficulties early is very important in achalasia.