Achalasia

Diagnosing Achalasia

How is it diagnosed?

If your GP thinks you have achalasia, you will be referred to hospital to have some diagnostic tests performed.

Barium swallow

A barium swallowinvolves drinking a white liquid containing the chemical barium, which allows the gullet to be seen and videoed on an X-ray.

In achalasia, the exit at the lower end of your gullet never opens properly, which causes a delay in barium passing into your stomach.

An ordinarychest X-ray may show a wide gullet.

Endoscopy

A flexible instrument called an endoscope is passed down your throat to allow the doctor to look directly at the lining of your gullet and stomach. Trapped food will be visible.

The endoscope can be passed through the tightmuscle at the bottom of your gullet and into your stomach to check there is no other disorder of the stomach.

A small plastic tube is passed into your gullet through your mouth or nose and the pressure at different points in your gullet is measured.

In achalasia, there are usually weak or absent contractions of the gullet and sustained high pressure in themuscle at the lower end of the gullet. The high pressure means themuscle does not relax in response to swallowing, causing symptoms of achalasia.

Medically Reviewed by a doctor on 18 Jan 2018

Articles for achalasia

Myths and facts about achalasia

Here are some myths and facts about achalasia

Introduction

Achalasia is a disorder of the gullet (oesophagus) where it loses the ability to move food along. The valve at the end of the gullet also fails to open and allow food to pass into your stomach. As a result, food gets stuck in your gullet and is often brought back up.

What are the symptoms?

Causes of Achalasia

Achalasia is caused by damage to and loss of the nerves in the gullet wall. The reason for this is unknown, although a viral infection earlier in life may be partly responsible. Achalasia may also be associated with having an autoimmune condition, where the immune system attacks healthy cells, tissue and organs. One recent study found people with achalasiaare significantly more likely to have an autoimmune conditionsuch as Sjogren's syndrome , lupus or uveitis .

Diagnosing Achalasia

If your GP thinks you have achalasia, you will be referred to hospital to have some diagnostic tests performed. Barium swallow: A barium swallowinvolves drinking a white liquid containing the chemical barium, which allows the gullet to be seen and videoed on an X-ray. Endoscopy: A flexible instrument called an endoscope is passed down your throat to allow the doctor to look directly at the lining of your gullet and stomach. Trapped food will be visible.

Treating Achalasia

The aim of treatment is to open the lower oesophageal sphincter muscle so food can pass into the stomach easily. The underlying disease cannot be cured but there are various ways to relieve symptoms which can improve swallowing and eating. The muscle at the lower end of your gullet may be temporarily relaxed by medication. If heartburn develops aftertreatment, consult your GP as medication may be needed to reduce the acid reflux.

Recovery from treatment

There are a few things you can do after dilatation or surgery to reduce symptoms: chew your food well, take your time eating, drink plenty of fluids with your meals, always eat food sitting upright, use several pillows or raise the head of your bed so that you sleep fairly upright, which prevents stomach acid rising into your gullet through the weakened valve and causing heartburn. If heartburn develops aftertreatment, consult your GP as medication may be needed to reduce the acid reflux.