As a top-rated gastroenterologist ion Manhattan's Upper West Side and throughout New York City, Dr. Jaffin has extensive experience using state-of-the-art techniques to diagnose and treat achalasia, a swallowing disorder that prevents food from entering the stomach from the esophagus.
Achalasia is a disorder that interferes with normal swallowing. Normally when we swallow, food passes through the esophagus and into the stomach. But in someone with achalasia, the muscular sphincter, or opening, at the base of the esophagus doesn't relax during swallowing, making it difficult or impossible for food to enter the stomach.
In addition to swallowing difficulties, achalasia can cause regurgitation of food into the esophagus as well as discomfort in the chest and back which may increase after eating. Heartburn and cough are also common.
Achalasia occurs when the nerves that control the lower esophageal sphincter, or LES, become damaged, interfering with the ability of the sphincter to relax and allow food to pass into the stomach. Researchers believe the damage may be the result of a faulty immune system response. Those with a family history of achalasia may also be more likely to develop the condition. People with achalasia often also have reduced muscle activity (peristalsis) throughout the entire esophagus.
Because it causes symptoms similar to other digestive disorders, achalasia can be very difficult to diagnose. In addition to a medical history including a review of symptoms, you may need to undergo diagnostic testing to evaluate the disease and to eliminate similar disease. Tests may include:
endoscopy to look inside your esophagus and to evaluate the function of the LES
high-resolution esophageal manometry, which uses a catheter to measure the function of your esophagus as you swallow
esophagram, an x-ray of your esophagus that uses barium as a contrast medium
Treatment involves helping the LES relax or forcing the sphincter to open so food passage is easier. An outpatients procedure called balloon dilation is one treatment options, and surgery are both possible options.