Overview

Achalasia is a swallowing condition that affects the tube connecting the mouth and the stomach, called the esophagus. Damaged nerves make it hard for the muscles of the esophagus to squeeze food and liquid into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth. This fermented food can taste bitter.

Achalasia is a fairly rare condition. Some people mistake it for gastroesophageal reflux disease (GERD). However, in achalasia, the food is coming from the esophagus. In GERD, the material comes from the stomach.

There's no cure for achalasia. Once the esophagus is damaged, the muscles cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery.

Symptoms

Achalasia symptoms generally appear gradually and get worse over time. Symptoms may include:

  • Difficulty swallowing, called dysphagia, which may feel like food or drink is stuck in the throat.
  • Swallowed food or saliva flowing back into the throat.
  • Heartburn.
  • Belching.
  • Chest pain that comes and goes.
  • Coughing at night.
  • Pneumonia from getting food in the lungs.
  • Weight loss.
  • Vomiting.

Get the latest health information from Mayo Clinic delivered to your inbox.

Subscribe for free and receive your in-depth guide to digestive health, plus the latest on health innovations and news. You can unsubscribe at any time. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

The exact cause of achalasia is poorly understood. Researchers suspect that it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses are possibilities. Very rarely, achalasia may be caused by an inherited genetic disorder or infection.

Risk factors

Risk factors for achalasia include:

  • Age. Although achalasia can affect people of all ages, it's more common in people between 25 and 60 years of age.
  • Certain medical conditions. The risk of achalasia is higher in people with allergic disorders, adrenal insufficiency or Allgrove syndrome, a rare autosomal recessive genetic condition.

July 19, 2024
  1. Achalasia. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/achalasia. Accessed March 8, 2024.
  2. Ferri FF. Achalasia. In: Ferri's Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed March 8, 2024.
  3. Achalasia. Canadian Society of Intestinal Research. https://badgut.org/information-centre/a-z-digestive-topics/achalasia/. Accessed March 12, 2024.
  4. Spechler SJ. Achalasia: Pathogenesis, clinical manifestations, and diagnosis. https://www.uptodate.com/contents/search. Accessed March 12, 2024.
  5. Reddy CA, et al. Achalasia is strongly associated with eosinophilic esophagitis and other allergic disorders. Clinical Gastroenterology and Hepatology. 2024; doi:10.1016/j.cgh.2023.06.013.
  6. Spechler SJ. Overview of the treatment of achalasia. https://www.uptodate.com/contents/search. Accessed March 12, 2024.
  7. Tasnim S, et al. Achalasia: Surgery versus per-oral endoscopic myotomy. Thoracic Surgery Clinics. 2023; doi:10.1016/j.thorsurg.2023.01.007.
  8. Ami TR. Allscripts EPSi. Mayo Clinic. April 17, 2024.

Related

Products & Services