Where in the digestive system does achalasia occur?

Achalasia is a rare disorder in which the esophagus is unable to move food and liquid into the stomach. It develops in about 1 in every 100,000 people in the USA each year. It is typically diagnosed in adults between the ages of 25 and 60, but can occur in children as well (less than 5% of cases are in children under age 16).

It occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people confuse it with gastroesophageal reflux (GERD). However, in achalasia the food comes from the esophagus, while in GERD the material comes from the stomach.

Its symptoms generally appear gradually and worsen over time. Signs and symptoms may include: Inability to swallow (dysphagia), which may feel like food or drink is stuck in your throat; Regurgitating food or saliva; Heartburn; Belching; Chest pain that comes and goes; Coughing at night; Pneumonia (from aspiration of food into the lungs); Weight loss; and Vomiting.

Currently, no treatments resolve achalasia entirely, but there are several approaches to relieve symptoms, such as dilation, surgery, botulinum toxin injections and medications. The goal of treatment is to normalize contractions in the esophagus and help the sphincter relax and allow food to pass into the stomach.