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Symptoms of Achalashia

Monday, July 19, 2010 @ 10:07 AM
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What is achalasia?

Achalasia is a rare disease of the muscle of the esophagus (swallowing tube). The term achalasia means "failure to relax" and refers to the inability of the lower esophageal sphincter (a ring of muscle situated between the lower esophagus and the stomach) to open and let food pass into the stomach. As a result, patients with achalasia have difficulty in swallowing food.

 

What are the symptoms of achalasia?

The most common symptom of achalasia is difficulty in swallowing (dysphagia). Patients typically describe food sticking in the chest after it is swallowed. Dysphagia occurs with both solid and liquid food. Moreover, the dysphagia is consistent, meaning that it occurs during virtually every meal.

Sometimes, patients will describe a heavy sensation in their chest after eating that may force them to stop eating. Occasionally, pain may be severe and mimic heart pain (angina). The cause of this discomfort is felt to be the accumulation of ingested food within the esophagus.

Regurgitation of food that is trapped in the esophagus can occur, especially when the esophagus is dilated. If the regurgitation happens at night while the patient is sleeping, food can enter the throat and cause coughing and choking. If the food enters the trachea (windpipe) and lung, it can lead to infection (aspiration pneumonia).

Because of the problem with swallowing food, a large proportion of patients with achalasia lose weight. Episodes of chest pain may also occur especially with vigorous achalasia. Sometimes symptoms suggest gastroesophageal reflux disease (GERD); however, it's not clear if the symptoms are, in fact, due to reflux. Moreover, acid suppression rarely improves the symptoms of achalasia.

What are the complications of achalasia?

The complications of achalasia include weight loss and aspiration pneumonia. There often is inflammation of the esophagus, called esophagitis, which is caused by the irritating effect of food and fluids that collect in the esophagus for prolonged periods of time. There may be esophageal ulcerations as well.

Of potential concern is the possibility that there is an increased occurrence of cancer of the esophagus in patients with achalasia. However, there is insufficient scientific evidence indicating that achalasia increases a person's risk of developing esophageal cancer, so authorities are currently not recommending that patients with achalasia undergo regular upper gastrointestinal endoscopy for cancer surveillance.

 

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