What is Achalasia?

Achalasia (acha-la-sia) is a rare motility disorder of the esophagus. The esophagus is the tube that connects the mouth to the stomach.

The muscles in the esophagus contract from top down (called peristalsis). This movement pushes food toward the stomach. If your child has achalasia, these muscles do not work right. Muscle contractions may be unable to move food through the esophagus.

Achalasia makes swallowing food and drink difficult. It can also cause the sphincter, or valve, at the lower end of the esophagus to become tight. This makes it difficult for the food to get to the stomach. Food can get stuck in the esophagus for a long time and lead to vomiting.

What Causes Achalasia?

Achalasia is caused when some of the nerve cells in the muscles of the esophagus don’t send signals to the brain. Nerve cells are needed to tell the muscles of the esophagus to push food and drink to the stomach.

Researchers are not sure why problems with the nerves happen. Some reasons may include:

• Genetics
• Autoimmune reaction
• Viral infection

Achalasia sometimes occurs with other conditions, including Allgrove syndrome or Down syndrome.

What Are The Symptoms of Achalasia?

Common achalasia symptoms in children include:

• Trouble swallowing
• Vomiting undigested food
• Pain or burning feeling in the chest
• Coughing (especially at night)
• Not gaining weight or weight loss

What Is The Treatment for Achalasia?

We work with families to understand your child’s medical history, symptoms and goals. Then, we’ll work with specialists across Cincinnati Children’s to make sure we find the right answers for your child and your family.

Common treatments include:

• Endoscopic balloon dilation to stretch tightened muscles in the lower end of the esophagus. This is done under anesthesia with an endoscope, a lighted tubular instrument.
• Esophagomyotomy, or laparoscopic Heller myotomy. This surgery is done under anesthesia. It involves placing a long cut in the narrowed muscles at the end of the esophagus. This “opens up” the sphincter or valve and allows food to pass more easily into the stomach.
• Partial fundoplication is often done with an esophagomyotomy. The procedure takes a small part of the upper stomach and wraps some of it around the lower esophagus. This helps stop acid and food that is in the stomach from backing up into the esophagus.

When to Call the Doctor

If your child is having a hard time swallowing food, contact a doctor. Symptoms of achalasia worsen over time, so it’s important to get a diagnosis early.

Call our Neurogastroenterology and Motility Disorders Center at 513-803-0776 to learn how we diagnose and treat achalasia.