Swallowing disorder could be achalasia

November 7, 12:15 PMGrand Rapids Public Health ExaminerNancy Zielinski

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Achalasia is a disorder of the esophagus that makes it difficult to swallow food or liquids. According to the Cleveland Clinic approximately 3000 people in the U.S. are diagnosed with it each year.

Symptoms of achalasia

Difficulty swallowing food or liquids is usually the first symptom that develops for those with achalasia (also referred to as dysphagia). The esophageal muscles do not contract normally thus hindering the ability to swallow. Additionally, the esophageal muscles may not relax properly to allow food to enter the stomach. As the condition develops and worsens, those afflicted by it commonly experience regurgitation of undigested food, heartburn, and chest pain. Weight loss and malnutrition develop when the sufferer is unable to keep any food down whatsoever.

Methods of diagnosis

• Barium swallow - Tests the movement of a barium solution that is swallowed. An x-ray is used to look for any blockages in the esophagus.
• Endoscopy - An instrument is passed down the throat to view the esophagus.
• Manometry – A tube is inserted into the esophagus that measures muscle contractions of the esophagus while swallowing.

Treatment may include the following

• Esophageal dilatation – A doctor inserts an endoscope down the throat with a special balloon attached to stretch and expand the width of the esophagus.
• Heller myotomy – A surgical procedure whereby the muscles of the valve between the esophagus into the stomach are cut. This procedure is performed through an open incision in the abdomen or the left side of the chest between the ribs.
• Botulinum toxin injection (Botox) – A somewhat new treatment whereby Botox is injected into the esophageal muscle to relax muscles and reduce spasms. It works by preventing nerves from sending signals to the muscles that tell them to contract.

As always, there are risks involved with any procedure. Look for a doctor that has a lot of experience treating achalasia. The Mayo Clinic and the Cleveland Clinic have staff that specialize in this disorder.