Achalasia

Etiology

  • Idiopathic loss of inhibitory neuron input to lower esophageal sphincter, leading to impaired relaxation of smooth muscle and impaired ability of food to leave esophagus and enter stomach

Risk Factors

  • Ages 30-60
  • M = F

Symptoms

  • Very slowly progressive dysphagia (months to years), w/subtle onset
  • Dysphagia is to solids and liquids
  • Usually do not have GERD sx; though can have a chest pain/pressure/squeezing sensation
  • Food sticks lower area esophagus; regurgitation
  • Pooling of saliva on pillow in AM
  • Nocturnal coughing
  • Sometimes hx recurrent aspiration pneumonia
  • Often mild weight loss

Tests