Achalasia Cardia: When Swallowing Becomes a Daily Struggle

Achalasia Cardia is a rare but impactful esophageal disorder in which the food pipe (esophagus) loses its ability to push food down into the stomach. In addition, the lower esophageal sphincter (LES) — the valve at the junction of the esophagus and stomach — fails to relax properly. As a result, food and liquids get stuck, causing difficulty in swallowing and significant discomfort in daily life.

Why Does Achalasia Happen?

In most cases, the exact cause is unknown. The nerves that control the esophageal muscles gradually stop functioning, leading to:
• Loss of peristalsis (movement of the food pipe)
• Tight LES that doesn’t relax
• Progressive widening of the esophagus over time

Achalasia can affect people of any age but often presents between 20–60 years.

Common Symptoms

Achalasia usually progresses slowly, and many patients struggle for years before receiving a correct diagnosis. Common symptoms include:

1. Difficulty in Swallowing (Dysphagia)
• Trouble swallowing solids at first
• Later, difficulty swallowing liquids too
• Food feels “stuck” in the chest

2. Regurgitation
• Undigested food coming back into the mouth
• Worse when lying down

3. Chest Pain or Discomfort
• Often mistaken for cardiac pain

4. Weight Loss
• Due to long-term difficulty in eating

5. Chronic Cough or Aspiration
• Food or saliva entering windpipe during sleep

How Achalasia is Diagnosed?

A combination of tests helps confirm the diagnosis:

1. Endoscopy

To rule out cancer-like conditions and check for esophageal dilation.

2. High-Resolution Manometry

The gold standard test — it measures muscle pressure in the esophagus and confirms the absence of peristalsis.

3. Barium Swallow Test

Shows a classic “bird-beak” narrowing at the lower end of the esophagus.

Treatment Options

Achalasia is a lifelong condition, but treatments provide excellent relief by weakening or cutting the tight LES muscle.

1. POEM (Peroral Endoscopic Myotomy)

Modern and highly successful treatment.
• No cuts or scars
• 30–45 minutes procedure
• Quick recovery
• Effective even in advanced or recurrent cases

2. Heller’s Myotomy (Surgery)

Laparoscopic surgery with good long-term results.

3. Pneumatic Balloon Dilatation

Stretching of the LES using a balloon.

4. Botox Injection

Temporary relief; used in select patients

Why POEM is Transforming Achalasia Care

POEM has become the preferred treatment worldwide because:
• It is minimally invasive
• Works well for all types of Achalasia
• Immediate improvement in swallowing
• Very low complication rate
• Faster recovery compared to surgery

Patients typically start liquids the same day and return home within 24–48 hours.

Life After Treatment

Most patients experience dramatic improvement:
• Ability to swallow normally
• Regain weight
• Improved confidence and quality of life
• Reduced regurgitation and night-time symptoms

Regular follow-up and diet guidance help maintain long-term results.

When to Seek Help?

If you or a loved one has long-standing difficulty swallowing, repeated regurgitation, or unexplained weight loss, it is important to consult an expert experienced gastroentrologist like a Dr. Kapil sharma in esophageal motility disorders and POEM.

Early diagnosis prevents unnecessary suffering and improves treatment outcomes.

Book an appointment or any query - +919311305777, +919625818164

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