From the Guidelines
Achalasia symptoms primarily include dysphagia to both solids and liquids, which is a key distinguishing feature from other oesophageal disorders. According to the UK guidelines on oesophageal dilatation in clinical practice 1, the characteristic symptom of oesophageal motility disorders, such as achalasia, is dysphagia to both solids and liquids. This is in contrast to benign strictures, where dysphagia is more pronounced for solids than liquids.
Key Symptoms
- Dysphagia to both solids and liquids
- Regurgitation of undigested food
- Chest pain after eating
- Heartburn
- Weight loss
- Coughing or choking when lying down As noted in the guidelines 1, oesophageal dilatation is an effective treatment for achalasia, aiming to alleviate symptoms, permit maintenance of oral nutrition, and reduce the risk of pulmonary aspiration. Patients with achalasia often experience a gradual worsening of symptoms over months or years, which can significantly impact their quality of life and nutritional status.
From the Research
Symptoms of Achalasia
The symptoms of achalasia include:
- Dysphagia to solids and liquids 2, 3, 4, 5
- Regurgitation 2, 3, 4, 5
- Chest pain 2, 4, 5
- Weight loss 2, 3, 4
- Aspiration 4
Clinical Presentation
Achalasia is characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent peristalsis in the smooth muscle esophageal body 2. Patients with achalasia often experience progressively severe symptoms, including dysphagia, regurgitation, and weight loss 3, 4.
Diagnosis and Treatment
The diagnosis of achalasia is suggested by barium swallow and endoscopy, and confirmed by manometry 4. Treatment options for achalasia include pneumatic dilation, laparoscopic Heller myotomy, and peroral endoscopic myotomy (POEM) 2, 3, 4, as well as botulinum toxin injection 5, 6. These treatments aim to reduce the lower esophageal sphincter pressure, resulting in improved esophageal emptying 5.