Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The most common symptom of achalasia is difficulty
in swallowing (dysphagia). Patients typically describe food sticking in the chest
after it is swallowed.
Dysphagia occurs with both solid and liquid food. Moreover, the dysphagia is
consistent, meaning that it occurs during virtually every meal.
Sometimes, patients will describe a heavy sensation
in their chest after eating that may force them to stop eating. Occasionally,
pain may be severe and mimic heart pain (angina).
The cause of this discomfort is felt to be the accumulation of ingested food
within the esophagus.
Regurgitation of food that is trapped in the esophagus can occur, especially
when the esophagus is dilated. If the regurgitation happens at night while the
patient is sleeping, food can enter the throat and cause coughing and choking.
If the food enters the trachea (windpipe) and lung, it can
lead to infection (aspiration pneumonia).
Because of the problem with swallowing food, a large proportion of patients with
achalasia lose weight. Episodes of chest pain may also occur especially with vigorous achalasia. Sometimes symptoms suggest
gastroesophageal reflux disease (GERD); however, it's not clear if the symptoms are, in fact, due to reflux. Moreover, acid suppression rarely improves the symptoms of achalasia.
What are the complications of achalasia?
The complications of achalasia include weight loss and
aspiration pneumonia.
There often is inflammation of the esophagus, called esophagitis, which is
caused by the irritating effect of food and fluids that collect in the esophagus
for prolonged periods of time. There may be esophageal ulcerations as well.
Of potential concern is the possibility that there is an
increased occurrence of cancer of the esophagus in patients with achalasia.
However, there is insufficient scientific evidence indicating that achalasia increases a
person's risk of developing esophageal cancer, so authorities are currently not recommending
that patients with achalasia undergo regular upper gastrointestinal endoscopy
for cancer surveillance.
Esophageal cancer is a disease in which malignant cells form in the esophagus. Risk factors of cancer of the esophagus include smoking, heavy alcohol use, Barrett's esophagus, being male and being over age 60. Severe weight loss, vomiting, hoarseness, coughing up blood, painful swallowing, and pain in the throat or back are symptoms. Treatment depends upon the size, location and staging of the cancer and the health of the patient.
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux, heartburn, viruses, medications that become stuck in the esophagus, allergy, asthma, hay fever, allergic rhinitis, and atopic dermatitis. Eosinophilic esophagitis symptoms include difficulty swallowing food, abdominal pain, chest pain, and heartburn.
Vitiligo is a condition in which the skin turns white due to the loss of pigment from the melanocytes, cells that produce the pigment melanin that gives the skin color.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
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