Achalasia

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 6 min read
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Achalasia is a rare disorder that makes it difficult for food and liquid to pass into your stomach. Achalasia occurs when nerves in the tube connecting your mouth and stomach (esophagus) become damaged. As a result, the esophagus loses the ability to squeeze food down,...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Achalasia is a rare disorder that makes it difficult for food and liquid to pass into your stomach. Achalasia occurs when nerves in the tube connecting your mouth and stomach (esophagus) become damaged. As a result, the esophagus loses the ability to squeeze food down, and the muscular valve between the esophagus and stomach (lower esophageal sphincter) doesn’t fully relax — making it difficult for...

Key Takeaways

  • This article explains Types of Achalasia: in simple medical language.
  • This article explains Causes of Achalasia: in simple medical language.
  • This article explains Symptoms of Achalasia in simple medical language.
  • This article explains How is Achalasia Diagnosed? in simple medical language.
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1

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Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

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Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

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Definition

Achalasia is a rare disorder that makes it difficult for food and liquid to pass into your stomach. Achalasia occurs when nerves in the tube connecting your mouth and stomach (esophagus) become damaged. As a result, the esophagus loses the ability to squeeze food down, and the muscular valve between the esophagus and stomach (lower esophageal sphincter) doesn’t fully relax — making it difficult for food to pass into your stomach.

Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach.

Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach.

There’s no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery.[rx]

Types of Achalasia:

  1. Classic Achalasia: This is the most common type, characterized by a lack of peristalsis (normal muscle contractions) in the esophagus and a non-relaxing lower esophageal sphincter (LES).
  2. Achalasia with Spastic Contractions: In this type, you may experience simultaneous spastic contractions along with the non-relaxing LES.

Causes of Achalasia:

  1. Unknown Cause: The exact cause of achalasia is still a mystery, but it may involve a malfunction of the nerves that control the esophagus.
  2. Autoimmune Factors: Some believe that the immune system might mistakenly attack the nerves in the esophagus.
  3. Genetics: There could be a genetic predisposition, as achalasia sometimes runs in families.
  4. Viral Infections: Certain viral infections may trigger the condition, although this is rare.
  5. Neurological Disorders: Conditions like Parkinson’s disease may increase the risk of achalasia.
  6. infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation: infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation in the esophagus may contribute to the development of achalasia.
  7. Environmental Factors: Exposure to certain environmental factors might play a role, although this is not well understood.
  8. Hormonal Changes: Some hormonal changes could potentially impact the functioning of the esophagus.
  9. Aging: Achalasia is more common in older adults.
  10. Obesity: Being overweight may increase the risk of developing achalasia.
  11. Smoking: Smoking has been associated with an increased risk of achalasia.
  12. Dietary Factors: A diet lacking in fruits and vegetables may be a contributing factor.
  13. Stress: While not a direct cause, stress could exacerbate symptoms.
  14. Alcohol Consumption: Excessive alcohol intake may worsen the condition.
  15. Injury or Trauma: Physical damage to the esophagus could lead to achalasia in some cases.
  16. Reflux Disease: Severe and long-standing acid reflux may contribute to achalasia.
  17. Previous Surgery: Certain surgeries involving the esophagus may increase the risk.
  18. Medications: Some medications, such as anticholinergics, may be linked to achalasia.
  19. Infections: In rare cases, infections like Chagas disease can cause achalasia.
  20. Radiation Therapy: Previous radiation therapy in the chest area could lead to achalasia.

Symptoms of Achalasia

  1. Difficulty swallowing (dysphagia).
  2. Regurgitation of undigested food.
  3. Chest pain or discomfort.
  4. Heartburn.
  5. Weight loss.
  6. Coughing.
  7. Choking.
  8. Bad breath (halitosis).
  9. Fatigue.
  10. Nighttime cough.
  11. Difficulty belching.
  12. Gurgling or bubbling sounds in the chest.
  13. Aspiration pneumonia.
  14. Hoarseness.
  15. Unintentional food or liquid intake into the lungs.
  16. Chronic lung problems.
  17. Malnutrition.
  18. Social withdrawal due to difficulty eating in public.
  19. Anxiety and depression.
  20. Pain or discomfort in the upper abdomen.

How is Achalasia Diagnosed?

To diagnose achalasia, doctors may use various diagnostic tests to understand the condition better:

Diagnostic Tests for Achalasia (20 common tests):

  1. Barium swallow test.
  2. Esophageal manometry.
  3. Upper endoscopy.
  4. 24-hour pH monitoring.
  5. High-resolution manometry (HRM).
  6. CT scan.
  7. X-rays.
  8. Blood tests.
  9. Esophagram.
  10. Video fluoroscopy.
  11. Upper gastrointestinal (GI) series.
  12. Biopsy.
  13. Radionuclide scanning.
  14. Impedance testing.
  15. Endoscopic ultrasound.
  16. Electromyography (EMG).
  17. Barostat testing.
  18. Magnetic resonance imaging (MRI).
  19. Pepsin testing.
  20. Bravo pH monitoring.

Treating Achalasia

Achalasia can be managed effectively through various treatment options. The choice of treatment depends on the severity of the condition and the patient’s overall health:

Treatment Options for Achalasia (30 possible treatments):

  1. Lifestyle modifications.
  2. Dietary changes.
  3. Medications to relax the LES.
  4. Botox injections to relax the LES.
  5. Balloon dilation (pneumatic dilation).
  6. Heller myotomy surgery.
  7. Peroral endoscopic myotomy (POEM).
  8. Fundoplication surgery.
  9. Gastrostomy tube insertion.
  10. Weight management.
  11. Physical therapy.
  12. Speech therapy.
  13. Behavioral therapy.
  14. Nutritional counseling.
  15. Dysphagia therapy.
  16. Esophageal stents.
  17. High-frequency electrical stimulation.
  18. Relaxation techniques.
  19. Yoga and breathing exercises.
  20. Chewing thoroughly.
  21. Elevating the head of the bed.
  22. Smaller, more frequent meals.
  23. Avoiding carbonated drinks.
  24. Esophageal dilation with bougies.
  25. Weighted nasogastric tube.
  26. Laparoscopic myotomy.
  27. Robotic-assisted surgery.
  28. Endoscopic injection therapy.
  29. Acupuncture.
  30. Herbal remedies.

Medications for Achalasia (20 common drugs):

There are certain medications that may be prescribed to help manage the symptoms of achalasia:

Drugs for Achalasia (20 common drugs):

  1. Nifedipine.
  2. Isosorbide dinitrate.
  3. Hyoscyamine.
  4. Omeprazole.
  5. Ranitidine.
  6. Baclofen.
  7. Botox injections.
  8. Nitroglycerin.
  9. Proton pump inhibitors (PPIs).
  10. Calcium channel blockers.
  11. Antacids.
  12. Steroids.
  13. Muscle relaxants.
  14. Tricyclic antidepressants.
  15. Anti-anxiety medications.
  16. Pain relievers.
  17. Antiemetics.
  18. Herbal supplements.
  19. Prokinetic agents.
  20. infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।" data-rx-term="anti-inflammatory" data-rx-definition="Anti-inflammatory means reducing inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।">Anti-inflammatory drugs.

Conclusion:

In summary, achalasia is a complex condition that affects the esophagus, causing difficulty in swallowing and other discomforting symptoms. While its exact cause remains uncertain, a range of treatments and medications can help manage the condition and improve the quality of life for individuals with achalasia. If you or someone you know experiences symptoms of achalasia, it is essential to seek medical attention promptly for proper diagnosis and treatment.

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.

 

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Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

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Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

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Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Emergency care / cardiology / medicine doctor
Tests to discuss with doctor
  • ECG as early as possible when chest pain suggests heart risk
  • Troponin or cardiac blood tests if doctor suspects heart attack
  • Blood pressure, oxygen level, chest examination, and other tests as advised urgently
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Is this heart-related, and do I need emergency observation?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Achalasia

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Types of Achalasia: Classic Achalasia: This is the most common type, characterized by a lack of peristalsis (normal muscle contractions) in the esophagus and a non-relaxing lower esophageal sphincter (LES). Achalasia with Spastic Contractions: In this type, you may experience simultaneous spastic contractions along with the non-relaxing LES. Causes of Achalasia: Unknown Cause: The exact cause of achalasia is still a mystery, but it may involve a malfunction of the nerves that control the esophagus. Autoimmune Factors: Some believe that the immune system might mistakenly attack the nerves in the esophagus. Genetics: There could be a genetic predisposition, as achalasia sometimes runs in families. Viral Infections: Certain viral infections may trigger the condition, although this is rare. Neurological Disorders: Conditions like Parkinson's disease may increase the risk of achalasia. Inflammation: Inflammation in the esophagus may contribute to the development of achalasia. Environmental Factors: Exposure to certain environmental factors might play a role, although this is not well understood. Hormonal Changes: Some hormonal changes could potentially impact the functioning of the esophagus. Aging: Achalasia is more common in older adults. Obesity: Being overweight may increase the risk of developing achalasia. Smoking: Smoking has been associated with an increased risk of achalasia. Dietary Factors: A diet lacking in fruits and vegetables may be a contributing factor. Stress: While not a direct cause, stress could exacerbate symptoms. Alcohol Consumption: Excessive alcohol intake may worsen the condition. Injury or Trauma: Physical damage to the esophagus could lead to achalasia in some cases. Reflux Disease: Severe and long-standing acid reflux may contribute to achalasia. Previous Surgery: Certain surgeries involving the esophagus may increase the risk. Medications: Some medications, such as anticholinergics, may be linked to achalasia. Infections: In rare cases, infections like Chagas disease can cause achalasia. Radiation Therapy: Previous radiation therapy in the chest area could lead to achalasia. Symptoms of Achalasia Difficulty swallowing (dysphagia). Regurgitation of undigested food. Chest pain or discomfort. Heartburn. Weight loss. Coughing. Choking. Bad breath (halitosis). Fatigue. Nighttime cough. Difficulty belching. Gurgling or bubbling sounds in the chest. Aspiration pneumonia. Hoarseness. Unintentional food or liquid intake into the lungs. Chronic lung problems. Malnutrition. Social withdrawal due to difficulty eating in public. Anxiety and depression. Pain or discomfort in the upper abdomen. How is Achalasia Diagnosed?

To diagnose achalasia, doctors may use various diagnostic tests to understand the condition better: Diagnostic Tests for Achalasia (20 common tests): Barium swallow test. Esophageal manometry. Upper endoscopy. 24-hour pH monitoring. High-resolution manometry (HRM). CT scan. X-rays. Blood tests. Esophagram. Video fluoroscopy. Upper gastrointestinal (GI) series. Biopsy. Radionuclide scanning. Impedance testing. Endoscopic ultrasound. Electromyography (EMG). Barostat testing. Magnetic resonance imaging (MRI). Pepsin testing. Bravo pH monitoring.

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