Achalasia is a rare esophageal motility disorder that affects the ability of the lower esophageal sphincter (LES) to relax. This causes difficulty swallowing and food movement from the esophagus to the stomach. Those who suspect they may have achalasia should seek medical evaluation and guidance from a physician experienced in managing this condition. This article will help one gain insight into the types, symptoms, causes, and treatment options for achalasia.

Types
There are three main types of achalasia, which are categorized based on their underlying causes and characteristics:

• Type I (classic achalasia): This subtype is characterized by the absence of peristalsis, where the esophageal contractions that propel food toward the stomach are severely impaired. This is the most common kind and occurs when the LES fails to relax properly, leading to a functional obstruction of the food pipe.
• Type II (achalasia with pan-esophageal pressurization): There is no peristalsis in this subtype, similar to type I, but there is additional pan-esophageal pressurization, which means simultaneous high-pressure contractions throughout the esophagus.
• Type III (spastic achalasia or jackhammer esophagus): This subtype has pan-esophageal pressurization and premature, high-amplitude, and prolonged contractions that mimic a “jackhammer” appearance.

Symptoms
Achalasia can exhibit a variety of symptoms, which may vary from person to person. Common indications include the following:

• Dysphagia: Difficulty swallowing, especially with solid foods, is one of the hallmark symptoms of achalasia. Patients may also experience regurgitation of undigested food.
• Chest pain: Some individuals with achalasia may experience chest pain or discomfort, which can be mistaken for heart-related issues.
• Weight loss: Unintended weight loss can occur due to difficulty eating and inadequate nutrient intake.
• Heartburn: Although achalasia is not caused by acid reflux, some patients may experience heartburn-like symptoms due to food pooling in the esophagus.
• Regurgitation: Regurgitation of undigested food or liquids, often accompanied by a sour taste, can occur in individuals with achalasia. This is due to the impaired ability of the lower esophageal sphincter to relax, allowing food to pass into the stomach.

Causes
The exact cause of achalasia is not fully known, but it is believed to involve the degeneration of nerve cells in the esophagus. The loss of these neurons disrupts the normal coordinated contractions that propel food toward the stomach. Some researchers have also suggested that genetic factors and autoimmune reactions may play a role in the development of achalasia.

Treatment
The treatment approach for achalasia aims to relieve symptoms, improve esophageal function, and prevent complications. Several therapy options are available. These are mentioned below:

• Pneumatic dilatation: This non-surgical procedure involves inflating a balloon within the LES to stretch it and improve swallowing function.
• Heller myotomy: This surgical procedure involves cutting the LES muscle to reduce tightness and allow for better food passage.
• Lifestyle changes: Modifying one’s eating habits, such as eating smaller and more frequent meals and avoiding trigger foods, can alleviate symptoms.

In conclusion, achalasia is a rare but significant esophageal disorder that can severely impact a person’s quality of life. Early detection and proper medical care are essential for managing symptoms and preventing complications.