Main Page | See live article | Alphabetical index Rare disease>Achalasia Achalasia or acalasia is a failure of a ring of muscle (as a sphincter) to relax (completely). Esophageal achalasia, also called simply achalasia, is a neuromuscular disorder of the esophagus characterized by the reduced ability to move food down the esophagus (peristalsis). In addition, the inability of the cardia ( also called lower esophageal sphincter)- to relax in response to swallowing (there is increased LES pressure- spasms). Synonyms : achalasia cardiae, cardiospasm, dyssynergia esophagus, esophageal aperistalsis. ICD code : 530.0 Table of contents 1 Signs and symptoms 2 Diagnosis 3 Complications 4 Treatment and new Expectations 5 External links Signs and symptoms Dysphagia Regurgitation of digested food Heartburn Chest pains : increases after eating and may radiate to the back, neck, and arms. Weight loss Coughing, especially at night or when lying down Diagnosis Due to the similarity of symptoms, achalasia can be misdiagnosed as other disorders, such as gastroesophageal reflux disease (GERD) and Chagas disease X-ray with a barium swallow or esophagography . Shows narrowing at the level of the gastroesophageal junction ("bird beak"), and various degrees of megaesophagus. Endoscopy, which provides a view from within the esophagus. Manometry, the key test for establishing the diagnosis. Measures the pressure induced in different parts of the esophagus and stomach during the act of swallowing. CT scan, which provides further visual evidence. Complications Gastroesophageal reflux disease-GERD or heartburn. Barrett's esophagus or Barrett's mucosa: in 10% of patients. There are two kinds of esophageal cancer: squamous cell carcinoma and adenocarcinoma. There are predisposing conditions that, if present for a long time, may lead to esophageal adenocarcinoma, like achalasia (in up to 5% of cases, Barrett's esophagus leads to esophageal adenocarcinoma). Treatment and new Expectations Balloon (pneumatic) dilation. The muscle fibers will be stretched. Gastroesophageal reflux (GERD) occurs after dilatation in 25% to 35% of patients. Is a risk to later Heller myotomy. Medication: Intra-sphincteric injection of botulinum toxin (or botox), to paralyze cardia and prevent spasms. It is transitory and symptoms will return in the majority of patients within a year. Drugs that reduce LES pressure such as nifedipine and nitroglycerin may be useful. Heller myotomy laparoscopic surgery. Transplant and artificial cardia. See also : endoscopy, esophageal motility disorder. External links International Rare Disease Support Network Email List Group for Achalasia. Anatomy and surgeries. Medlineplus. All about achalasia. U.S. National Guideline about achalasia. Emedicine. Intelihealth. Yahoo health encyclopedia. Meetup for achalasia sufferers. This article is from Wikipedia. All text is available under the terms of the GNU Free Documentation License.