Definition of Achalasia and Causes

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.

What is the definition of achalasia?


Achalasia can be defined as the lack of the lower esophageal sphincter to relax and the presence of abnormal motility in the remainder of the esophagus
Practice Essentials
Achalasia is a primary esophageal motility disorder characterized by the absence of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) in response to swallowing. The LES is hypertensive in about 50% of patients. These abnormalities cause a functional obstruction at the gastroesophageal junction (GEJ).

What is achalasia?

Achalasia is a rare disorder in which your esophagus is unable to move food and liquids down into your stomach. Your esophagus is the muscular tube that transports food from your mouth to your stomach. At the area where your esophagus meets your stomach is a ring of muscle called the lower esophageal sphincter (LES). This muscle relaxes (opens) to allow food to enter your stomach and contracts (tightens to close) to prevent stomach content from backing up into your esophagus. If you have achalasia, the LES doesn’t relax, which prevents food from moving into your stomach.

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, people with achalasia have difficulty swallowing food. In addition to the failure to relax, achalasia is associated with abnormalities of esophageal peristalsis (usually complete absence of peristalsis), the coordinated muscular activity of the body of the esophagus (which comprises 90% of the esophagus) that transports food from the throat to the stomach.

What causes achalasia?

Achalasia can happen for different reasons. It can be difficult for your doctor to find a specific cause. This condition may be hereditary, or it may be the result of an autoimmune condition. With this type of condition, your body’s immune system mistakenly attacks healthy cells in your body. The degeneration of nerves in your esophagus often contributes to the advanced symptoms of achalasia.

Other conditions can cause symptoms similar to achalasia. Cancer of the esophagus is one of these conditions. Another cause is a rare parasitic infection called Chagas’ disease. This disease occurs mostly in South America.

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.

Who is at risk for achalasia?
Achalasia usually occurs later in life, but it can also occur in children. Individuals who are middle-aged and older are at higher risk for the condition. Achalasia is also more common in people with autoimmune disorders.

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