Achalasia Treatment

What is Achalasia?

Achalasia is a rare esophageal condition in which the muscles of the lower esophagus lose the ability to relax, causing difficulties with swallowing (dysphagia) and potentially leading to significant discomfort and nutrition challenges. As the condition progresses, food and liquids struggle to pass smoothly into the stomach, leading to a persistent feeling of fullness or regurgitation. With the proper diagnosis and specialised treatment, however, relief is possible.

Understanding Achalasia in Australia

Achalasia is uncommon, affecting approximately 1 in 100,000 Australians each year. Though rare, the need for effective treatment is crucial for those impacted. Australia’s leading medical bodies, including the Gastroenterological Society of Australia, emphasise early detection and treatment, with endoscopic and surgical options being primary treatment routes. The condition is most commonly seen in adults between 25 and 60, but it can develop at any age.

Symptoms of Achalasia

Patients with achalasia often experience:

Difficulty swallowing food and liquids
Chest pain or discomfort, often described as a burning sensation
Regurgitation of food, particularly at night
Persistent cough, sometimes with traces of food or saliva
Weight loss due to eating challenges
A feeling of fullness after eating small portions

Causes of Achalasia

The exact cause of achalasia is not well understood, though it’s believed to involve the degeneration of nerves within the esophagus. This degeneration prevents the lower esophageal sphincter (LES) from relaxing properly, resulting in food blockage. Genetics and autoimmune factors may also contribute, though more research is needed to confirm these links.

Diagnostic Tests

Diagnosing achalasia requires careful evaluation and specific tests, including:

Esophageal Manometry: Measures muscle contractions and pressure in the esophagus.
Barium Swallow Test: Shows how food and liquid move through the esophagus using X-rays.
Endoscopy: Allows for visual examination of the esophagus and stomach, ruling out other causes of symptoms.
CT or MRI Scans: Used to check for any structural abnormalities.

Complications of Untreated Achalasia

Without treatment, achalasia can lead to significant complications, such as:

Malnutrition and weight loss due to difficulty eating
Development of esophageal strictures or narrowing
Risk of aspiration, which can lead to respiratory issues
Increased risk of esophageal cancer over time

Treatment Options

Treatment for achalasia aims to improve the passage of food into the stomach by relaxing or dilating the LES. Options include:

Heller Myotomy: A minimally invasive surgical procedure where the muscles at the lower end of the esophagus are cut, relieving the blockage.
Peroral Endoscopic Myotomy (POEM): A newer, endoscopic version of myotomy that allows for muscle relaxation through the mouth, with no external incisions.
Botox Injections: Temporarily relaxes the LES, often used as a short-term solution or for patients unable to undergo surgery.
Balloon Dilation: A non-surgical treatment that uses a balloon to stretch the LES, offering temporary relief for some patients.

There is no single ‘best’ option for treatment of achalasia in everyone. Therefore it is important to seek opinion from a surgical service that is able to provide all options and discuss them with patients to choose the best option for their circumstances.

For more information or to book a consultation with Dr Craven, please call us on (03) 9852 3777 or email us at info@dralexcraven.com.au.

Dr Alex Craven Provides Specialised Care In

Surgery for Obesity

Upper Gastrointestinal Surgery

General Surgery

Endoscopy

Weight and Obesity Control

Frequently Asked Questions

Is achalasia curable?

While there is no cure, achalasia can be managed effectively through procedures that improve swallowing and reduce symptoms.

How long does recovery take after Heller Myotomy or POEM?

Most patients recover within a few weeks, with some immediate symptom improvement. Dietary adjustments may be needed in the short term.

Are lifestyle changes helpful for achalasia?

Yes, minor lifestyle changes, like eating smaller meals, staying upright after eating, and avoiding late meals, can help alleviate symptoms.

Achalasia treatment involves a combination of advanced diagnostics, minimally invasive procedures, and compassionate care to help patients regain comfort and quality of life.

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