What are the Symptoms of Achalasia of the Esophagus?

Achalasia of the esophagus occurs when the lower esophageal sphincter (LES) that normally allows food to pass into the stomach is too tight. Solid foods and liquids have trouble making it through the tube, resulting in significant swallowing difficulties. Other symptoms of achalasia of the esophagus can vary from person to person, but most patients experience food regurgitation, mild chest pains, and weight loss. People who are able to recognize and explain early symptoms of achalasia of the esophagus to their doctors can aid in making sure they receive accurate diagnoses and treatments.

The LES normally expands and contracts at a regular rate to help food make its way to the digestive tract. If the muscles controlling the LES are unable to relax, passing food is slow, difficult, and sometimes painful. Problems swallowing even small bites of food or sips of liquid are the most common symptoms of achalasia of the esophagus. When food clings to the esophagus, the upper chest and throat feel tight and sometimes painful. Choking can occur with a large bite or when trying to swallow an especially thick liquid.

Additional symptoms of achalasia of the esophagus may include regurgitating food back into the mouth, weight loss, and fatigue. Food that does not make it to the stomach accumulates in the throat until it cannot be contained anymore. After a medium to large meal, it is common for a person to vomit. Since it is undigested material, the vomit is much dryer and tougher in consistency than typical vomit that is coated with stomach acid. Symptoms of weight loss, dehydration, and fatigue are results of not being able to ingest enough foods and liquids over a period of time.

When symptoms of achalasia of the esophagus become chronic, additional problems can arise. Inflammation and swelling can develop because undigested materials constantly irritate the lining of the tube. In some cases, a very painful ulcer can form that makes eating and drinking virtually unbearable.

It is important to report symptoms to a doctor whenever they become a persistent nuisance. A physician can take imaging scans and peer into the esophagus with a camera to confirm achalasia. Specialized muscle relaxants are commonly prescribed to promote better LES functioning. If symptoms fail to improve with medications, a doctor may suggest surgery to clip the muscles around the LES, temporarily paralyze the sphincter, or remove it altogether. Most people who seek treatment are able to find quick, significant symptom relief.