Achalasia - Causes

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What causes achalasia?

The cause of achalasia is unknown. Theories on causation invoke infection, heredity or an abnormality of the immune system that causes the body itself to damage the esophagus (autoimmune disease).

The esophagus contains both muscles and nerves. The nerves coordinate the relaxation and opening of the sphincters as well as the peristaltic waves in the body of the esophagus. Achalasia has effects on both the muscles and nerves of the esophagus; however, the effects on the nerves are believed to be the most important. Early in achalasia, inflammation can be seen (when examined under the microscope) in the muscle of the lower esophagus, especially around the nerves. As the disease progresses, the nerves begin to degenerate and ultimately disappear, particularly the nerves that cause the lower esophageal sphincter to relax. Still later in the progression of the disease, muscle cells begin to degenerate, possibly because of the damage to the nerves. The result of these changes is a lower sphincter that cannot relax and muscle in the lower esophageal body that cannot support peristaltic waves. With time, the body of the esophagus stretches and becomes enlarged (dilated).

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See what others are saying

Comment from: Dawn, 45-54 Male (Patient) Published: November 02

When my daughter was 11 months old she was very sick. I went to the doctors 3 times within 2 days, before they sent me to the hospital. When I arrived there they initially told me she had croup and dehydrated. She was in an oxygen tent, and after a couple of days the doctor told me that she was seriously ill. He said she had strep in the blood system and had to have IV antibiotics. My grand-daughter who is 2 years seems to have the same and has been to the doctors 3 times and went to the hospital as she was having trouble breathing and unable to keep her temperature down. They told my daughter that it is croup and gave her oxygen and antibiotics and watched her for a couple of hours before sending her home. My daughter did mention to the doctors what happened to her but nothing was done about it. No blood or urine was taken. I have tried to read up on it and only can find it happens to newborns or up to 3 months.

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Comment from: Joyce, 75 or over Female (Patient) Published: May 03

In 1974, 8 months of being unable to eat, I was told it was in my mind, I had anorexia, bulimia, even Munchausensyndrome. Finally I was operated on; my esophagus was strangled. They removed the sphincter. I have had 42 years of continued pain because of achalasia. Now I am 88 and it is getting worse, I have vile pain in my back, and am going for another endoscopy. Almost hoping news will be bad as I simply cannot cope with this pain anymore. In 1984 the pain of it caused me to have a heart attack and then by-pass surgery. I am worried it could happen again and also could be cancer. Funny no one seems to understand what achalasia is; they say that is just reflux. I go to bed hoping I do not wake up again.

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