Achalasia

Achalasia is a rare digestive disorder that makes it hard to eat and drink normally. The disorder affects your esophagus — the swallowing tube that connects the back of your throat to your stomach. If you have achalasia, the ring of muscle that circles the lower portion of your esophagus (lower esophageal sphincter valve) does not relax and as a result, your food or liquid does not pass easily into your stomach.

Although achalasia has no cure, treatments are available. Achalasia affects about 2,000 people in the United States every year. Learn more about esophageal achalasia, including symptoms and risks.

Board certified general and gastrointestinal surgeons at Brigham and Women’s Hospital (BWH) are experts at diagnosing and treating achalasia with minimally invasive surgical approaches such as laparoscopic Heller myotomy.

Diagnosis of Achalasia

If your doctor suspects achalasia from your symptoms, he or she may order these tests to confirm your diagnosis:

Learn more about diagnostic tests for achalasia.

Treatment for Achalasia

No treatment can restore normal esophageal movement, but minimally invasive surgery and medical treatments can relieve your symptoms and open up the lower esophageal sphincter valve.

Surgical Treatment

Laparoscopic esophagomyotomy or Heller myotomy is a minimally invasive surgical technique that uses the da Vinci® Surgical System to open the tight valve between the esophagus and the stomach, allowing food to pass through.
Per oral endoscopic myotomy (POEM) is a highly specialized and advanced endoscopic procedure that usually provides long-term relief from symptoms. This minimally invasive operation is indicated in certain cases and may be accomplished without skin incision.

Non-Surgical Treatment

Pneumatic dilation, also called balloon dilation, is an outpatient procedure done under light anesthesia. While your doctor looks into your esophagus through an endoscope, an air-filled balloon is passed through the valve between the esophagus and stomach and inflated.
Botox is a medication that can paralyze muscles. Botox can be injected into the muscles that control your lower esophageal sphincter to relax the valve opening.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have achalasia and what course of treatment is needed. Careful monitoring and the involvement of an experienced general and gastrointestinal surgeon are important to the successful outcome for patients with esophageal conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with achalasia. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Brigham and Women's Hospital provides a multidisciplinary approach to patient care by collaborating with colleagues who have extensive experience diagnosing and treating achalasia and esophageal conditions. In addition, patients have full access to BWH's world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

General and Gastrointestinal Surgery Appointments and Locations

Resources

Go to our health library to learn more about achalasia.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.

Access a complete directory of patient and family services.