Discovering that food is getting stuck in your throat can be a terrifying experience, often leading to rapid weight loss and severe anxiety around meal times.
This practical guide explains what achalasia is, how it disrupts the normal digestive process, and the advanced treatment options available to restore normal swallowing.
A Motility Disorder: Achalasia is a rare condition that affects the oesophagus (the muscular tube connecting your mouth to your stomach).
The Tight Valve: Because of this nerve damage, the lower esophageal sphincter (the muscular valve at the bottom of the tube) fails to relax and open, creating a physical bottleneck that prevents food and liquids from entering the stomach.
Dysphagia: The primary symptom is difficulty swallowing both solid foods and liquids, often leaving patients with the distinct sensation that food is securely wedged in the center of their chest.
Regurgitation: Because food cannot pass into the stomach, it pools in the esophagus and is frequently coughed or brought back up, completely undigested.
Chest Pain and Weight Loss: Many patients experience a sharp, burning chest pain after eating (often mistaken for severe heartburn) and suffer significant, unintended weight loss due to an inability to eat full meals.
Barium Swallow: Patients drink a chalky barium liquid while X-rays are taken. In achalasia, this highlights a severely stretched esophagus that tapers into a tight, narrow point at the bottom, known clinically as a “bird’s beak” appearance.
Oesophageal Manometry: This is the gold-standard diagnostic tool. A thin, pressure-sensitive tube is passed through the nose into the esophagus to measure the strength and coordination of the muscle contractions as you swallow water.
Endoscopy: A camera is passed down the throat to physically view the esophagus, allowing specialists to rule out other potential causes of swallowing blockages, such as esophageal cancer.
Pneumatic Dilation: Under sedation, a specialized balloon is passed down into the tight lower valve and inflated. This intentionally stretches and disrupts the tight muscle fibers to widen the passage.
POEM (Peroral Endoscopic Myotomy): This is a cutting-edge, minimally invasive endoscopic procedure where a surgeon passes a camera through the mouth to cut the tight muscle fibers at the bottom of the esophagus, permanently releasing the valve.
Heller Myotomy: A traditional keyhole (laparoscopic) surgery where the surgeon cuts the muscles of the lower esophageal sphincter from the outside, usually combined with a partial anti-reflux procedure to prevent severe heartburn later.
Dietary Textures: While awaiting or recovering from treatment, opt for soft, puréed, or liquid-based foods. Chew every single bite exceptionally thoroughly before attempting to swallow.
Postural Habits: Always sit completely upright while eating and remain standing or walking for at least 30 to 60 minutes after a meal to allow gravity to help pull food down into your stomach.
Nighttime Safety: Elevate the head of your bed using pillows or a mattress wedge to prevent dangerous nighttime regurgitation and coughing fits while you sleep.
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