Achalasia

Body outline showing the stomach, esophagus, and intestines, with a close-up of a tight lower esophageal sphincter.

Your esophagus is the part of your body that moves food from your mouth to your stomach. When you swallow, muscles in a part of your esophagus called the lower esophageal sphincter (LES) relax to let food into your stomach.

If the muscles don't relax like they should, you may have a condition called achalasia. This can cause there to be more pressure near the LES. It can also make it hard for you to swallow.

What are the causes?

The cause of this condition is not known.

What increases the risk?

You may be more likely to get achalasia if:

You're 30–60 years old.
Someone else in your family has the condition.
You have a disease that affects your body's defense system (immune system). This includes:
- Diabetes.
- Hypothyroidism.
- Sjögren's syndrome.
- Systemic lupus erythematosus (SLE).

What are the signs or symptoms?

Symptoms may include:

Trouble swallowing or pain when you swallow.
Coughing.
Making high-pitched whistling sounds when you breathe, most often when you breathe out. This is also called wheezing.
Heartburn or trouble burping.
Chest pain.
Vomiting.
Weight loss.
Bad breath.

How is this diagnosed?

Achalasia may be diagnosed based on your symptoms, your medical history, and an exam. You may also need tests. These may include:

X-rays.
A barium swallow test. During this test, you swallow a chalky liquid that makes your esophagus easier to see. Then X-rays are taken.
An endoscopy. This is when a tube called an endoscope is used to check your esophagus.
Esophageal manometry. This checks if there's more pressure on your LES.

How is this treated?

There's no cure. But treatment can help with symptoms. It may include:

Medicines.
An endoscopy procedure. A balloon may be used to stretch your esophagus.
Surgery. This may involve cutting the muscles that won't relax.
A shot of botulinum toxin. This helps your muscles relax.

Follow these instructions at home:

Eating and drinking

Try to eat soft foods that are easy to swallow.
When you eat:
- Sit upright.
- Cut your food into small pieces.
- Eat slowly.

General instructions

Take over-the-counter and prescription medicines only as told by your health care provider.
Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your provider.

Contact a health care provider if:

Your symptoms don't go away with treatment.
You have new symptoms.
You have a fever.
Your pain gets worse.
Your belly swells.
You vomit every time you eat or drink.

Get help right away if:

You vomit blood.
You have chest pain.
You have trouble breathing.

These symptoms may be an emergency. Get help right away. Call 911.

Do not wait to see if the symptoms will go away.
Do not drive yourself to the hospital.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.