Achalasia is an esophageal disorder that affects about 1 in 100,000 individuals annually. Although it is usually diagnosed in adults, it can also happen in children. The esophagus, also known as the food pipe, is the tube that transports food from the mouth to the stomach. When one has achalasia, it becomes difficult for the esophagus to transport food to the stomach. The intestines are part of the digestive system that is susceptible to achalasia.

Learning more about the condition
Achalasia is an uncommon condition in which one’s esophagus is unable to transport food and liquids from the mouth to the stomach. The junction where one’s food pipe connects to the stomach is a band of muscle called the lower esophageal sphincter (LES). This muscle relaxes (opens) to enable food into the stomach and contracts (tightens) to keep stomach contents from flowing back into the esophagus. When one has achalasia, the LES does not open, preventing food from entering the stomach.

Types of achalasia
These are the three different types of the condition that have been discovered based on the reason for esophageal disability.

• Type 1 – Classic achalasia is another name for type 1. In this condition, the esophageal muscles hardly tighten, allowing gravity to move the food downward.
• Type 2 – The esophagus becomes compressed due to gas buildup in type 2 of the condition. This form is the most prevalent and frequently results in more serious symptoms than type 1.
• Type 3 – It occurs because there are abnormal spasms at the point where the esophagus and stomach converge at the bottom. Type 3 is also referred to as spastic achalasia, which is the most serious form. Chest pain brought on by contractions has the power to wake someone up from slumber and mimic the signs of a heart attack.

Causes

• When a person swallows, the LES muscle relaxes to enable food to enter the stomach. This does not happen in individuals with achalasia. Furthermore, normal esophageal muscle activity called peristalsis is reduced or nonexistent. This condition is triggered by esophageal nerve damage.
• Other problems, such as cancer of the esophagus or upper stomach, and a parasite infection that causes Chagas disease, which is more prevalent in Mexico, and Central and South America, can cause similar symptoms.
• As stated earlier, this condition can happen at any age, but it is most prevalent in people between the ages of 25 and 60 years. Moreover, the problem may be inherited in some individuals.
• According to a study, achalasia is caused by damage to specific cells in one’s involuntary nervous system. An autoimmune reaction results in the damage of these neurons. The phagocytic cells in one’s body target the muscle layers in the esophagus, causing tissue deterioration and loss of function.

Symptoms
The signs and symptoms appear gradually and can last months or even years. These include:

• Difficulty eating (dysphagia) is the most prevalent initial sign of the condition
• Spitting up while eating food
• Pain in the chest that comes and goes and may sometimes be severe
• Heartburn
• Nighttime coughing
• Malnutrition as a result of eating problems is an advanced sign
• Cramps and trouble breathing ( a less common symptom)

Treatment
Esophageal achalasia or the nerve function cannot be fully reversed by treatment. However, there are methods to reduce the severity of symptoms.

• Minimally Invasive Surgery
  The procedure used to treat the condition is known as a laparoscopic Heller myotomy or esophagomyotomy. During this minimally invasive process, an endoscope, a thin telescope-like tool is introduced through a tiny incision. A view of the surgery site is broadcasted on the operating room video monitors. This is made possible with the tiny camera that is connected to the endoscope. The LES’s muscular fibers are cut during this procedure. As a precautionary measure to prevent gastroesophageal reflux disease that can set in as a result of the Heller myotomy operation, partial fundoplication surgery may be performed. Heller myotomy can be replaced with a slightly invasive procedure called peroral endoscopic myotomy (POEM).
• Other therapeutic solutions
  Certain chemical formulations can help widen the narrowed portion of the esophagus, if the condition gets identified early before its progression. However, some may cease working after a few months and a person might need to seek other treatments if this happens.
• Balloon Dilation
  This is a non-surgical treatment. A specially made balloon is inserted through the LES and inflated. As a result of the process, the patient’s muscle sphincter relaxes, allowing food to pass into the stomach. In cases where surgery is unsuccessful, balloon inflation is typically the first course of action. To eliminate the symptoms, one might need to have several dilation procedures, followed by periodic treatments every few years.