3. Introduction
• Achalasia is a condition caused by damaged
esophageal nerves, resulting in paralysis and
dilation of the esophagus.
• The muscle in the esophagus fails to move
food into the stomach effectively.
• Achalasia affects approximately 8 to 12
individuals per 100,000.
4. Causes and
Terminology
• Achalasia is named after the failure of the
lower esophageal sphincter (LES) to relax.
• Nerve damage in the esophagus is the
primary cause of achalasia.
5. Symptoms
• Dysphagia: Difficulty swallowing liquid or
solid food.
• Regurgitation: Backflow of food or liquid into
the throat.
• Chest pain
• Heartburn
• Weight loss
6. Stages
• Achalasia can be categorized into four stages
based on the maximum barium diameter
and shape in the esophagus.
• Stage 1: Barium diameter ≤ 4 cm
• Stage 2: Barium diameter = 4-6 cm
• Stage 3: Barium diameter ≥ 6 cm, straight
esophagus
• Stage 4: Barium diameter ≥ 6 cm, sigmoid-
shaped esophagus
7. Types
•Type 1: Achalasia is sometime called classic
achalasia. …
•Type 2: in this type of achalasia pressure
builds up in the esophagus, causing it to
become compressed. …
• Type 3: Achalasia is sometimes called spastic
achalasia because there is abnormal
contraction at the bottom of the esophagus
where it meets to the stomach. …
8. Complications
• Achalasia is a lifelong condition that can
cause serious complications if left untreated.
These complications include:
•Aspiration pneumonia: When food or liquid
backs up into the throat and is breathed into
the lungs.
•Esophageal perforation: A hole in the
esophagus.
9. Complications
(Continued
•Esophageal cancer: People with achalasia
have a higher risk of developing esophageal
cancer.
•Pulmonary complications: These include lung
abscess, empyema, and aspiration
pneumonia.
• However, with symptom management,
people with achalasia can avoid the most
serious complications.
10. Diagnosis
• Esophageal manometry is the gold standard
for diagnosing achalasia.
• It measures muscle pressure along the
esophagus.
• Other diagnostic tests include barium
swallow, where X-rays are taken after
drinking a barium-containing liquid.
11. Surgical
Treatment
• Heller myotomy: Surgeons cut the muscles
at the end of the esophagus and top of the
stomach.
• Peroral endoscopic myotomy (POEM):
Minimally invasive surgical approach for
severe achalasia.
12. Nonsurgical
Treatment
• Pneumatic dilation: A balloon is inserted into
the esophageal sphincter and inflated to
enlarge the opening.
• Medication: Muscle relaxants such as
nitroglycerin or nifedipine may be prescribed
before meals.
13.
14. Treatment Goals
• The goal of treatment is to normalize
contractions in the esophagus and promote
relaxation of the LES.
• This helps facilitate food passage into the
stomach.
15. Conclusion
• Achalasia is a condition characterized by
paralysis and dilation of the esophagus due
to nerve damage.
• Symptoms include dysphagia, regurgitation,
chest pain, heartburn, and weight loss.
• Diagnosis involves tests like esophageal
manometry and barium swallow.
• Treatment options include surgery,
pneumatic dilation, and medication.
• The primary goal is to alleviate symptoms
and improve esophageal function.
