Achalasia: A Disorder of the Esophagus. Achalasia is a rare disorder in which damaged nerves in your esophagus prevent it from working as it should. Muscles at the lower end of your esophagus fail to allow food to enter your stomach. Symptoms include trouble swallowing, heartburn and chest pain.

1. Digestive system
diseases
Esophageal Achalasia

2. Esophageal Achalasia
Neuromuscular dysfunction due to which
the LES sphincter fails to relax during
Swallowing
↓
results in progressive dysphagia and
↓
dilatation of the esophagus (mega-
esophagus).
Source - DSSurgery

3. Etiology
Primary idiopathic achalasia
• i.e. Congenital
Secondary achalasia
• Chagas disease, in which Trypanosoma
cruzi infection causes
• destruction of the myenteric plexus,
• failure of peristalsis, and esophageal
dilatation.
• Duodenal, colonic, and ureteric
myenteric plexuses can also be affected in
Chagas disease

4. Diagnosis
Source – Mount Sinai
Esophageal manometry
↓
done to see
↓
• Esophageal peristalsis
• swallowing problems.
• During the test, the doctor can also
check the LES to see if it opens and
closes properly

5. Source – St Vincents University Hospital
Barium swallow test
• The test involves swallowing a chalky-tasting, thick
mixture of barium while x-rays are taken.
• The barium shows the outline of the esophagus and
lower esophageal sphincter (LES)

6. Treatment
Pneumatic dilation. A balloon is inserted by
endoscopy into the center of the esophageal
sphincter and inflated to enlarge the opening
Botox (botulinum toxin type A). This muscle
relaxant can be injected directly into the
esophageal sphincter with an endoscopic
needle.
Source – The Lancet
Source - Springetlink

7. laparoscopic Heller myotomy
surgeon cuts the muscle at the lower end
of the esophageal sphincter to allow food
to pass more easily into the stomach.
Source - LHSC

8. Thanks