Achalasia

What is achalasia?

At first it may only cause a minor problem, and often goes unnoticed. However, over time someone with achalasia finds it increasingly difficult to swallow food and liquid.

This is because the muscles in the oesophagus (gullet) which move foods and liquids into the stomach stop working properly. This leads to the oesophagus dilating, or stretching, which may lead to choking or coughing fits at night, triggered by food or liquids being regurgitated when a sufferer lies down at night.

Treatment and recovery

A chest X-ray or a barium meal may suggest the diagnosis. This is usually confirmed during endoscopy, when a fibre-optic camera is used to look inside the gullet and stomach.

Initially, symptoms can be improved temporarily by medication, if the diagnosis is made in the early stages of the disease, or, if made later on, by dilating the narrowed part of the gullet to allow food to pass more easily. This can be achieved by inflating a small balloon in the narrowed section to stretch it.

Performing an operation in which the muscle is surgically cut to prevent further obstruction can treat most cases of achalasia. This operation is called a myotomy and its success rate is 85 to 95 per cent.

If people are unfit or unable to have surgery, botox injections can be used to relax the tense muscles of the lower part of the gullet, but this treatment only lasts for three months at a time.