What is achalasia and how is it treated?
Achalasia is a condition in which the nerves in the esophageal wall have been damaged. The cause of this injury is unknown, but its effects are well recognized. With this condition, the esophagus is unable to contract in a coordinated manner and the lower esophageal sphincter does not relax with swallowing. This results in food remaining in the esophagus above a closed sphincter segment. Treatment is directed toward weakening the sphincter muscle, after which food will empty by gravity. Routine dilation, such as that used for strictures (see above) is usually ineffective. Effective treatments include dilation with a large size balloon dilator, botulinum toxin injection in the lower esophageal sphincter, or surgical myotomy (a procedure in which the LES is cut). The best approach depends upon the situation, local expertise, and the patient’s personal preference. The choice should be made after a consultation in which these factors can be considered and discussed. What is the treatment f
