Ideally, every time you swallow, food and liquid go down your esophagus, the long tube that leads to your stomach.
The muscles of the esophagus move the food downward, and when it reaches the bottom of the tube, it meets a sphincter, which is normally in the closed position to prevent stomach acid from bubbling back up. The sphincter then opens up and lets the food drop into your stomach.
But in a rare condition called esophageal achalasia, the muscles in your esophagus don’t contract and release, so your food can’t make its way to your stomach, at least not easily.
Gravity may lend a helping hand and coax some of what you swallow to slide down, but when it gets to the lower esophageal sphincter, it’s denied access. The sphincter stays shut and doesn’t allow the food to enter your stomach.
The food just sticks in your esophagus and feels like a ball of food wedged in your throat. With nowhere to go, your food may come back up and out your mouth.
If this sounds familiar and you think you might be suffering from esophageal achalasia, there’s only one way to find out. You need specialized diagnostic tests, which experienced medical professionals like our team at Rockland Thoracic and Vascular Associates can administer.
Only about 3,000 cases of esophageal achalasia are diagnosed in America every year, which explains why you may not have heard of it. But if you’re one of them, you’ve likely been searching for answers and relief for your symptoms.
Here our experts explain your treatment options and strategies that may help you live more comfortably with esophageal achalasia.
How to tell if you have esophageal achalasia
The classic symptoms of esophageal achalasia are the inability to swallow food and drink, heartburn, regurgitation, and chest pain after eating a meal. You also may notice unwanted weight loss.
The only way to know for sure if you have this condition (or something else wrong with your esophagus) is through diagnostic testing.
In this test, we insert a slim, flexible tube with a tiny camera on the end down your throat so we can see the inside of your esophagus to determine if there are any visible problems such as tumors or damage.
Similar to an endoscopy, the esophageal manometry test involves a long, narrow tube in your throat, but this time we ask you to swallow something during the test. The instrument allows us to evaluate how your muscles move and whether they are malfunctioning.
Barium is a chalky white substance that absorbs X-rays. We mix it with water so you can drink it and coat your esophagus. We then use an X-ray to highlight your esophagus and determine whether you have structural or functional problems.
Living with esophageal achalasia
The cause of esophageal achalasia is unknown, but possibilities include an autoimmune disorder, past viral infection, and genetics. If you have it, your priority is finding a way to deal with it.
Although there is no cure for esophageal achalasia, there are ways you can make living with it a little easier.
- Eat slowly
- Chew your food very well
- Drink plenty of water with your meal, even sipping water as you chew
- Don’t eat late at night or close to bedtime
- Prop your head up when you sleep
- Avoid foods that cause acid reflux
These techniques may offer you a small measure of relief, but they’re mainly coping skills that are effective for those with mild cases. If your symptoms are interfering with your ability to eat and maintain weight, you may need to consider medical intervention.
The first course of treatment is to dilate the lower esophageal sphincter enough to allow food to enter the stomach. We insert a small balloon-like instrument into your esophagus and gently stretch the sphincter. For many sufferers, this simple procedure is all it takes to restore enough functionality and reduce symptoms.
For others, we may need to repeat the process, but the chances for success with this treatment decline with each attempt.
If dilation doesn’t work, we may recommend a laparoscopic esophagomyotomy. This surgical procedure involves a few quarter-inch incisions so we can access your lower esophagus.
We incise the malfunctioning sphincter and then create a new sphincter out of the top portion of your stomach by wrapping it around the lower part of your esophagus. This helps prevent acid reflux.
About 95% of people who have this surgery get at least some measure of relief from their esophageal achalasia.
If you’re suffering from esophageal achalasia, treatment is possible. To schedule a consultation with our team of thoracic specialists, call one of our five locations or use our convenient online appointment request tool.
Our offices are located in Pomona, Goshen, Fishkill, and the Fort Washington section of Manhattan in New York and in Englewood, New Jersey. We look forward to seeing you soon.