Achalasia is a rare motility disorder that affects a person’s ability to empty their esophagus, or in other words, their ability to swallow. This disability occurs when the lower end of the esophagus — called the lower esophageal sphincter (LES) — fails to open to let food through into the stomach. The term “achalasia” actually means “failure to relax.”
This impaired relaxation of the LES muscle is felt in different degrees by different people. For example, it is very rare for a patient to lose their ability to swallow completely because of achalasia, but most patients experience a very difficult time swallowing, which results in the back-up of food within the esophagus.
The way each patient experiences achalasia can also be tied to the achalasia types from which they suffer.
There are three different achalasia types, simply referred to as Type I, Type II, and Type III. Each achalasia type has its own set of characteristics, and they can all be diagnosed with an esophageal manometry. It should be noted that these classifications are still somewhat new and only discernible with a high-resolution manometry diagnostic method.
Type I achalasia is characterized by minimal esophageal pressurization. This type describes “classic” achalasia, which is characterized by the incomplete relaxation of the LES, a lack of mobility in terms of contraction and relaxation, and a small amount of pressure built up in the esophagus. This type of achalasia is easiest to treat.
Type 2 achalasia points to esophageal compression. This type of achalasia is a little more severe and characterized by more massive compression in the esophagus, often caused by the failure to relax and the build-up of pressure in the esophagus, typically from food.
Type 3 achalasia defines achalasia with spasms that result in sudden, abnormal squeezing of the esophagus and the LES. This type of achalasia is the most severe and can also elicit the most severe symptoms, such as severe chest pains that may mimic those of a heart attack, and spasms severe enough to wake you from sleep.
There are several ways of treating achalasia that including medications, Botox, a balloon dilation, and surgery. Typically, Tampa Bay Reflux Center do not recommend medications, since these are relatively ineffective and need to be taken for life, which can cause other complications and side effects.
Botox is a good but fairly short-term solution for Achalasia that needs to be repeated often and can become very pricey. Balloon Dilation is the most popular, non-surgical method for treating achalasia. This method provides relief of symptoms for a decent amount of time, but it’s also not a permanent fix.
The only long-term solution for the treatment of achalasia is a Heller Myotomy; a surgical procedure in which the muscles of the lower esophageal sphincter are cut and then partially rebuilt. This method allows for food and liquids to pass through the esophagus and the LES easier.
If you are suffering from achalasia, or think you may be, please give us a call today to schedule an appointment. Our reflux surgeons are incredibly knowledgeable board-certified surgeons who you can sit with and have a consultation. Whoever you consult with, Dr. Grandhige or Dr. Tapper, they will be able to address all of your achalasia questions and concerns.