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Pediatric Achalasia

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Summary

Achalasia is a neurological disorder affecting the nerves throughout the entire length of the esophagus. It forces the lower esophageal sphincter, called the LES, to remain closed during swallowing, preventing the esophagus from moving food toward the stomach. The normal function of peristalsis is also affected.

Expanded Overview

Achalasia is rare and diagnosed in about 2,500 people in the United States every year. Only about 10% of cases occur in children, most of them boys.There might be a genetic component to the condition.

Symptoms

  • Coughing spells after eating
  • Dysphagia (difficulty swallowing) 
  • Halitosis and heartburn
  • Regurgitation of undigested food 
  • Thoracic pain
  • Weight loss 

Diagnosis

An upper 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 its tone and pressure. An endoscopy is also used to get a close-up image of the problem.

Treatment

Most children with achalasia require surgery to decrease the pressure at the LES. Dilation of the esophagus may offer another surgical approach. Technological advances in minimally invasive surgery make these procedures easier, which is why pediatric doctors favor them.

After surgery, medication is often prescribed, including calcium-channel blockers, botulinum toxin and slow-release nitrates. 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.

 

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