Managing Achalasia Treatment: A Smoother Road Ahead

Jan 1, 2024

Achalasia — a condition affecting the esophagus — can be challenging for those diagnosed. Achalasia is a disorder that affects the ability of the esophagus to move food toward the stomach, causing symptoms like difficulty swallowing, regurgitation of food, and chest pain. However, managing achalasia has become more feasible, offering a smoother road ahead for patients.

How & Why Does Achalasia Happen?

Achalasia occurs due to the dysfunction of the esophagus—a muscular tube responsible for transporting food from the mouth to the stomach. The exact cause of achalasia isn’t always clear, but several factors contribute to its development:

1. Esophageal Sphincter Abnormalities

The muscle ring at the junction of the esophagus and stomach is called the lower esophageal sphincter. It is supposed to relax to allow food to pass into the stomach. In achalasia, the LES fails to settle correctly or becomes tight, impeding the passage of food.

2. Nerve Damage

Loss of Nerve Cells in the Esophagus: The esophagus requires a coordinated effort between muscles and nerves to propel food. Damage to the nerves in the esophagus, particularly the ganglion cells responsible for muscle relaxation, can contribute to achalasia.

3. Autoimmune Factors

Immune System Response: Some evidence suggests that achalasia might involve an autoimmune response, where the body’s immune system mistakenly attacks the nerves in the esophagus, disrupting their function.

Symptoms and Complications

The main symptoms associated with achalasia include:

  • Dysphagia (Difficulty Swallowing): Due to the impaired relaxation of the esophageal sphincter, food struggles to pass into the stomach, causing difficulty in swallowing solids and liquids.
  • Regurgitation: Undigested food and saliva may return to the mouth, causing discomfort and sometimes aspiration into the lungs, leading to respiratory issues.
  • Chest Pain: Some individuals experience chest pain or discomfort, often mistaken for heart-related issues due to location.

What Is A Day With Achalasia Like?

Living with achalasia can present daily challenges that affect various aspects of life. Here’s an insight into what a day might be like for someone with achalasia:


  • Waking Up: Often, individuals might wake up with a lingering feeling of discomfort or a sensation of food remaining in the esophagus from the previous night’s meal.
  • Breakfast: Consuming breakfast might involve careful choices of easily digestible or liquid foods to minimize discomfort and difficulty swallowing.

Throughout the Day

  • Eating Habits: Meals are planned meticulously, focusing on softer textures, smaller bites, and thorough chewing to aid swallowing.
  • Regular Monitoring: There might be a constant awareness of symptoms and monitoring for any signs of food regurgitation or chest discomfort.
  • Medication: If prescribed, taking medications to help relax the esophagus or manage symptoms might be a routine part of the day.

Challenges and Adjustments

  • Dysphagia Management: Coping with difficulty swallowing might mean slower eating, avoiding certain foods that trigger symptoms, and sometimes refraining from meals in social situations to prevent discomfort or embarrassment.
  • Discomfort and Pain: Chest pain or discomfort can be a recurring issue, impacting daily activities or work.


  • Dinner Considerations: Dinner choices might be similar to breakfast—focused on softer or liquid options to ease swallowing.
  • Post-Meal Rest: Taking time to rest or sit upright after meals to allow food to settle and reduce the risk of regurgitation or discomfort.
  • Preparation for Sleep: Some individuals might adjust sleeping positions or elevate their head to minimize nighttime reflux or discomfort.

Emotional Impact

  • Anxiety or Frustration: The constant need for caution during meals and the unpredictability of symptoms can lead to anxiety or frustration about eating and social situations.
  • Impact on Social Life: Managing achalasia can sometimes limit social activities involving meals, leading to feelings of isolation or self-consciousness.

Seeking Support & Treatment Options

Living with achalasia demands adaptability, patience, and a proactive approach to managing symptoms. It involves navigating physical discomfort, making conscious dietary choices, and seeking medical and emotional support to enhance the quality of daily life despite the conditions’ challenges.

Regular follow-ups with healthcare providers might be necessary to monitor symptoms, adjust treatments, or explore new management options. Seeking support from online forums and support groups or connecting with others facing similar challenges can also provide valuable emotional support and coping strategies.

The goal of treating achalasia is to alleviate symptoms and improve esophageal function. Several approaches exist:

  • Medication: Medications that help relax the esophageal sphincter or reduce spasms can provide temporary relief, although they may not be a permanent solution.
  • Botox Injections: In some cases, botulinum toxin injections (Botox) can be administered into the esophageal sphincter to relax the muscle temporarily.
  • Dilation: Esophageal dilation, a procedure where the sphincter is dilated using an inflatable balloon, can help improve swallowing.
  • Surgery: Surgical options like a Heller myotomy involve cutting the muscles of the esophageal sphincter to allow easier passage of food into the stomach.
  • Peroral Endoscopic Myotomy (POEM): A minimally invasive procedure where the lower esophagus muscles are cut using an endoscope inserted through the mouth, allowing for improved swallowing.

Lifestyle Modifications

Alongside medical interventions, specific lifestyle changes can complement achalasia management:

  • Dietary adjustments: Soft or liquid foods might be easier to swallow.
  • Eating habits: Eating slowly, chewing thoroughly, and avoiding large meals can reduce symptoms.
  • Posture during meals: Sitting upright and maintaining a good eating posture can aid digestion.

The Road Ahead

While managing achalasia can be a journey with its challenges, the advancements in treatment options offer hope and relief. Patients can work closely with healthcare providers to explore personalized approaches that suit their conditions and lifestyles. With a combination of medical treatments, lifestyle adjustments, and a supportive network, individuals can navigate this condition and pave a smoother road toward a better quality of life. Contact us today to learn more about our medical resources and how we can help.