Achalasia - Symptoms

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What are the symptoms of achalasia?

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.

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Comment from: Deanna, 25-34 Female (Patient) Published: August 19

For many years I had problems regurgitating food soon after I had eaten. What came up didn't look like vomit but rather just like chewed food. It was odd then I started to have odd abdominal pain occasionally after I ate when I went to the doctor to figure out what was going on they had me do a barium swallow and I was diagnosed with Achalasia when the barium didn't enter my stomach after 5 minutes.

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Comment from: Linda, 55-64 Female (Patient) Published: August 02

My first symptom was while eating white rice. I could not get it to go down, and I had terrible pain in the middle of my chest. I went to the restroom and leaned over, and the rice came out and the pain got easier but was still there. It got to the point after about a year that even water would not go down. I lost about 40 pounds. I had some tests done and was told I had achalasia after an upper GI. I then had mobility testing done over 10 times. At that point, I was sent to a surgeon and had the surgery to cut the muscle and make a new opening into the stomach. It has helped me over the years, but I've had to have stretching done about once a year to loosen scar tissue that has formed. Also my stomach does not empty properly and takes longer. Recently, my daughter was diagnosed with achalasia and is waiting to have the same surgery as I did. I did not know that I could pass this onto my children, but I do now!

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