Achalasia

Difficulty swallowing. Regurgitation. Unintentional weight loss. You’ve lived with the symptoms of achalasia long enough. Find expert achalasia treatment from Michigan’s top swallowing specialists. At Henry Ford Health’s Center for Motility Disorders, you receive personalized, multidisciplinary care and access to the latest minimally invasive procedures.

What is achalasia?

Achalasia is a swallowing disorder that occurs when the nerves and muscles in your esophagus (tube that carries food and liquid from your throat to your stomach) don’t work properly. The muscles at the bottom of your esophagus (lower esophageal sphincter) are too tight and don’t relax. Instead of moving food into your stomach, the food stays in your esophagus for too long.

Achalasia may result from esophageal nerve damage, a virus or an autoimmune disorder. In most cases, the cause is unknown.

Achalasia symptoms

Common symptoms of achalasia include:

• Chest pain
• Coughing or choking
• Dysphagia (difficulty swallowing)
• Feeling of food being stuck in your throat or chest
• Heartburn
• Regurgitation (spitting up undigested food and liquid)
• Unintentional weight loss

How is achalasia diagnosed?

Since achalasia doesn’t typically have a clear cause, it can be a frustrating condition for many people. Our swallowing disorder specialists use the latest motility tests to gather as much information as possible about your condition so that we can build the right treatment plan.

Tests for achalasia may include:

• Timed barium esophagram test: A barium esophagram (barium swallow test) uses X-rays to take pictures of your upper GI tract. You swallow a contrast liquid, which coats your throat and esophagus so that these structures appear more detailed on X-rays. This test shows us if you have a narrowed esophagus or other structural problems causing your symptoms.
• Esophageal motility study: Also called esophageal manometry, this test measures how well the muscles in your esophagus work. We insert a catheter (thin, flexible tube) with pressure sensors through your nostril, down your throat and into your esophagus. When you swallow, the sensors tell us if your esophageal muscle contractions are normal.
• EndoFLIP®: EndoFLIP (endoluminal functional lumen imaging probe) is the latest diagnostic test to measure esophageal function. A catheter equipped with a special balloon measures the pressure, size and stiffness of your esophagus. The motility experts at Henry Ford have specialized expertise performing this sophisticated test.

Learn more about how we diagnose motility disorders at Henry Ford.

Achalasia treatment at Henry Ford

At Henry Ford, we understand that swallowing disorders can affect every aspect of your life, from your diet and sleep to your emotional well-being. A multispecialty team works together to build a treatment plan tailored to your needs and preferences.

Achalasia treatment aims to help food move from your esophagus into your stomach more easily. Treatments range from dietary changes to minimally invasive procedures such as peroral endoscopic myotomy (POEM).

Depending on your age, symptoms and overall health, we may recommend:

• Dietary changes: Achalasia may improve by taking smaller bites of food, chewing carefully, drinking plenty of fluids and eating slowly. Your dietitian might recommend softer foods such as soups and smoothies.
• Botulinum toxin injections: We use Botox® injections (delivered through an endoscope) to relax the esophageal sphincter muscles.
• Esophageal dilation: We use an endoscope and special dilation tools, such as balloons, to widen your esophageal sphincter. You’re sedated during this noninvasive procedure.
• Laparoscopic Heller myotomy: This minimally invasive surgery for achalasia involves several small incisions in your abdomen. A surgeon cuts your lower esophageal sphincter muscles to widen the valve.

Peroral endoscopic myotomy (POEM )

The POEM procedure is an advanced, minimally invasive achalasia treatment. Your endoscopist inserts an endoscope through your mouth and guides it to your lower esophageal sphincter. They cut the sphincter muscles from inside your esophagus, so you don’t have any incicions in your abdomen. POEM is an alternative to the Heller myotomy.

Henry Ford is a among only a few centers in the region performing POEM. Our expertise with this and other endoscopic procedures gives people suffering from achalasia new hope for relief.