What is achalasia?

Achalasia is a rare but serious disease in the digestive system, which mostly manifests itself with **difficulty swallowing food** and **food sticking in the chest**. In this disease, the esophagus cannot properly transport food to the stomach because its end muscles do not open well. This causes food and liquids to accumulate in the esophagus and the person feels discomfort, pain or even food returns to the mouth. Although there is no definitive treatment for achalasia, there are various methods that can reduce its symptoms and improve the patient's quality of life. In this article, we will examine the symptoms, causes and ways of treating this disease in simple language, so that if you or those around you are facing such a problem, you will have more knowledge about it. What are the symptoms of achalasia? Achalasia disease usually starts gradually and silently. Many patients initially feel only a little difficulty in swallowing, but over time, this problem becomes more severe and more bothersome symptoms appear. Below we examine the most important symptoms of this disease: Difficulty swallowing solid foods and liquids - Feeling of food stuck in the chest - Regurgitation of food or liquids in the mouth - Burning or pain in the chest area - Cough or suffocation during sleep - Weight loss for no apparent reason - Watery mouth - Bitterness in the mouth, especially in the morning - burping - Feeling of stomach fullness after a small amount of food If you experience any of these symptoms consistently, especially difficulty swallowing or regurgitation, it is best to see a gastroenterologist. Early diagnosis of achalasia can prevent the progression of the disease and the occurrence of more serious complications. Many people mistake these symptoms for simple problems like reflux or anxiety, but ignoring them can make the treatment process more difficult. What is the cause of achalasia? The exact cause of achalasia is still not fully known, but most research shows that this disease is caused by **damage to the nerves of the esophageal muscles**. In a normal state, the contraction and relaxation of the muscles of the esophagus causes food to move towards the stomach, but in achalasia, this function is impaired and the circular muscle at the end of the esophagus (lower sphincter) does not open properly. - Damage to the nerve cells in the esophagus wall - The body's autoimmune response to esophageal nerve cells - Past viral infections (e.g. herpes virus or measles) - Genetic factors in some people - Some rare neurological or muscular diseases Can achalasia be treated? In most cases, achalasia is recognized as **idiopathic** (that is, without a specific cause), but as mentioned, **neural and autoimmune** factors play a prominent role in its development. In short, achalasia is more of a neuromuscular disease than a structural problem. That is, the main problem is in the nerve and motor function of the esophagus, not in its appearance. Treatment of achalasia **Achalasia is a disorder in the esophagus that causes food and liquids to enter the stomach with difficulty, because the muscle at the end of the esophagus (inferior sphincter) does not relax and the natural movements of the esophagus to guide food are lost.** This problem is associated with symptoms such as difficulty in swallowing, sticking food, returning food or saliva, and sometimes chest pain. The treatment of achalasia is not to remove the cause, but its purpose is to reduce the sphincter pressure and make the passage of food easier. Depending on the patient's condition, methods such as (temporary) botox injection, balloon dilation, Heller myotomy surgery or endoscopic POEM method are used. These treatments help the patient to eat more easily and have a better quality of life. What people get achalasia? Achalasia can occur at any age, but is most common in young to middle-aged adults. Although this disease is rare, knowing who is more susceptible to it can help in faster diagnosis. In the following, you will get to know the groups that are more likely to have achalasia: - It is mostly seen in **people between 25 and 60 years** Its prevalence in men and women is almost equal - In some cases, **familial or genetic background** has been seen - It is slightly more likely to occur in **people with autoimmune diseases** - In Latin American countries, Chagas parasitic infection can be the cause of achalasia In general, achalasia is a disease that is not easy to predict, but if you are in high-risk groups and have suspicious symptoms, it is better to consult a doctor as soon as possible. Early diagnosis can prevent the progression of the disease. Can achalasia be treated? **No, achalasia does not have a definitive cure, but it is manageable.** With methods such as **esophageal dilation (balloon therapy), surgery (Hallar myotomy)** and **endoscopic treatments (such as POEM)**, symptoms can be greatly reduced and swallowing can be improved. Also, in some cases, muscle relaxants or Botox injections help temporarily. The goal of the treatment is to reduce the pressure at the end of the esophagus and help the food pass more easily into the stomach. How long does achalasia patients live? In most cases, the lifespan of patients with achalasia is normal, provided that the disease is diagnosed in time and appropriate treatment is given. Achalasia is not usually fatal, but if left untreated, it may lead to **complications such as severe dilatation of the esophagus, malnutrition, or, in rare cases, esophageal cancer**. With proper care and regular follow-up, most patients can live long and healthy lives. What is the difference between achalasia and reflux or other digestive diseases? In terms of symptoms, achalasia may at first glance be confused with diseases such as GERD or esophageal spasm, but there are important differences between them. In achalasia, the main problem is in the movement of food from the esophagus to the stomach, while in reflux, the main problem is the return of stomach acid to the esophagus. - Treatment of achalasia usually requires **more specialized methods such as expansion or surgery**; But reflux is often controlled with medication and diet. - In achalasia, swallowing food is difficult; In reflux, swallowing is usually normal, but heartburn is present. - Achalasia is associated with **food getting stuck in the chest**, but reflux causes more **heartburn**. - Reflux is aggravated by consuming fatty or spicy foods; While achalasia is progressive and gets progressively worse. In general, although the symptoms of achalasia are similar to some other digestive diseases, **the type and progression of symptoms are different**. Accurate diagnosis of this disease is only possible through specialized investigations such as manometry or endoscopy. For this reason, if you have trouble swallowing or feeling stuck in food, it is better to avoid self-medication and definitely consult a specialist doctor. **Is achalasia a dangerous disease?** **Yes, if left untreated, it can be dangerous.** If left untreated, achalasia can lead to problems such as **dilation of the esophagus, ulcers, respiratory infections from regurgitation** and, in rare cases, **increased chances of esophageal cancer**. But the good news is that if the disease is diagnosed early and receives proper treatment, most of its complications can be avoided and lead a healthy life. Ways to diagnose achalasia To diagnose achalasia, the doctor first pays attention to the patient's symptoms, but more detailed tests are needed to confirm the diagnosis. The most important method is **Esophageal manometry**, which measures the function of the muscles of the esophagus and is the most accurate way to diagnose this disease. **barium swallow ** is also used; In this method, the patient drinks a white liquid and the abnormal shape of the esophagus is determined by taking a picture. **Endoscopy** is also used to directly view the inside of the esophagus and stomach to rule out other problems such as tumors or ulcers. In some special cases, **advanced imaging such as CT scan or MRI** may also be performed. Together, these methods help the doctor to diagnose achalasia with high accuracy. Summary Achalasia is a rare but important disease in the gastrointestinal tract, which is mostly characterized by difficulty in swallowing, food sticking, and regurgitation of the contents of the esophagus into the mouth. Although the exact cause is still unknown, damage to the nerves of the esophageal muscles plays a major role. Diagnosis of this disease requires tests such as **manometry, barium swallow and endoscopy**. Although there is no definite cure for achalasia, its symptoms can be controlled to a great extent with methods such as **esophageal dilatation, surgery or endoscopic treatment**. If you or someone close to you has symptoms similar to this disease, it is recommended to see a gastroenterologist as soon as possible. Early diagnosis is the key to preventing complications and living a healthier life.