Achalasia: Difficulty In Swallowing Food

Have you ever felt like food is getting stuck in your throat or chest when you eat? Do you struggle to swallow, no matter how much water you drink? If so, you might be dealing with a condition called achalasia.

Achalasia is a rare disorder that affects the esophagus, the tube responsible for carrying food and liquid from your mouth to your stomach. In people with achalasia, the muscles of the esophagus don’t work properly, and the lower esophageal sphincter (LES)—a muscular ring at the bottom of the esophagus—fails to relax as it should. As a result, food has trouble passing into the stomach, leading to discomfort, regurgitation, and other complications.

Table of Contents

• Symptoms of Achalasia
• What Causes Achalasia?
• How is Achalasia Diagnosed?
• Treatment Options for Achalasia
• Lifestyle and Dietary Adjustments for Achalasia
• When to See a Doctor?
• Final Thoughts

Symptoms of Achalasia

Swallowing difficulties can be frustrating and even frightening. If you have achalasia, you may experience symptoms such as:

• Difficulty swallowing (dysphagia) – You may feel like food is getting stuck in your throat or chest. It might start with solid foods and eventually progress to liquids as well.
• Regurgitation of food or liquid – Undigested food might come back up, especially when lying down.
• Chest pain or discomfort – You may feel a tight, squeezing sensation that can sometimes be mistaken for heart problems.
• Heartburn or acid reflux – Even though achalasia isn’t caused by excess stomach acid, food lingering in the esophagus can create a burning sensation similar to acid reflux.
• Unintended weight loss – Because eating becomes difficult, many people unintentionally lose weight over time.
• Chronic coughing or choking – Especially at night, food or liquids may enter the airway, leading to coughing or aspiration pneumonia.

What Causes Achalasia?

Doctors and researchers are still studying the exact cause of achalasia, but it is believed to be linked to:

• Nerve damage – The nerves that control the esophageal muscles may degenerate over time, leading to dysfunction.
• Autoimmune response – Some scientists suspect that the immune system mistakenly attacks the nerves of the esophagus.
• Genetic factors – Although rare, some families have a history of achalasia, suggesting a possible hereditary component.
• Viral infections –  A past viral infection may trigger the immune system to attack the esophageal nerves.

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How is Achalasia Diagnosed?

If you’re experiencing persistent difficulty swallowing, your doctor may recommend one or more tests to diagnose achalasia:

• Esophageal manometry – This test measures the pressure and muscle activity in your esophagus to see how well it functions.
• Barium swallow test – You’ll drink a special liquid that shows up on X-rays, allowing doctors to observe how it moves through your esophagus.
• Endoscopy– A thin, flexible tube with a camera is inserted down your throat to examine your esophagus and rule out other conditions like GERD or esophageal cancer.

Treatment Options for Achalasia

Achalasia is a chronic condition, meaning it doesn’t go away on its own. However, there are several treatment options that can help improve swallowing and reduce symptoms:

1. Balloon Dilation (Pneumatic Dilation)

In this procedure, a small balloon is inserted into the lower esophageal sphincter and inflated to stretch it open. This can provide significant relief, but the procedure may need to be repeated over time as symptoms return.

2. Botox Injections

Botox (botulinum toxin) can be injected into the lower esophageal sphincter to relax the muscles, making swallowing easier. However, the effects are temporary, and injections may need to be repeated every few months.

4. Surgical Options (Heller Myotomy)

In a Heller myotomy, the muscles of the lower esophageal sphincter are cut to allow food to pass through more easily. This is often combined with fundoplication, a procedure to prevent acid reflux.

5. POEM (Peroral Endoscopic Myotomy)

This is a minimally invasive endoscopic procedure that helps restore esophageal function by making internal cuts to the muscle layers. It has shown promising results with fewer complications.

Lifestyle and Dietary Adjustments for Achalasia

In addition to medical treatments, making lifestyle and dietary changes can help you manage symptoms effectively:

• Chew your food thoroughly and eat at a slow pace – This helps with easier swallowing and better digestion.
• Drink water with meals – Sipping water between bites can help food move down smoothly.
• Avoid foods that are difficult to swallow – Tough meats, dry foods, and fibrous vegetables may worsen symptoms.
• Eat smaller, more frequent meals – Instead of large meals, try eating smaller portions throughout the day.
• Stay upright after eating – Lying down right after meals can worsen regurgitation, so try to stay upright for at least 1-2 hours.
• Sleep with your head elevated – Using an adjustable bed or extra pillows can help reduce nighttime regurgitation.

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When to See a Doctor?

If you frequently struggle with swallowing, experience unexplained weight loss, or have chest pain that isn’t related to heart issues, it’s crucial to see a doctor. Early diagnosis and treatment can prevent complications and significantly improve your quality of life.

Final Thoughts

Living with achalasia can be challenging, but you don’t have to suffer in silence. With proper diagnosis, treatment, and lifestyle adjustments, you can manage symptoms and enjoy a better quality of life. If you suspect you have achalasia, don’t hesitate to seek medical advice—getting the right help can make all the difference!