Achalasia is a condition that affects the coordination of the esophagus making it difficult to eat.
Achalasia causes the lower esophageal sphincter, called the LES, to remain closed during swallowing, preventing the esophagus from propelling food toward the stomach. The normal function of peristalsis is also affected.
Achalasia is diagnosed in about 2,500 people in the United States every year. Only about 10% of cases occur in children.
Common signs and symptoms may include:
An upper gastrointestinal (GI) X-ray is the first step to obtain a general diagnosis of the disorder. It is usually followed by an esophageal manometry to measure esophageal tone, pressure, and coordinated motion of the esophagus. An endoscopy is also used to get a close-up image of the problem.
Most children with achalasia require surgery to relieve the high pressure at the LES. Dilation of the LES may offer some benefit, but often the results are short term. Technological advances in minimally invasive surgery make these procedures simpler and easier for patients.
Medications such as calcium-channel blockers, botulinum toxin and slow-release nitrates rarely provide long-term relief of symptoms.
For most patients, surgery and medication provide a moderate level of long-term dysphagia control. This will allow your child to have an improved quality of life.