Achalasia

Achalasia is a rare disease of the oesophagus, characterised by difficulty in the passage of food from the oesophagus to the stomach. It results from abnormal oesophageal motility and inadequate relaxation of the lower oesophageal sphincter, which remains excessively contracted.

The main symptoms include dysphagia for solids and liquids, food regurgitation, retrosternal chest pain and a sensation of food blockage in the chest. In more advanced stages, weight loss and malnutrition may occur.

Diagnosis is based on clinical assessment and complementary investigations, namely upper gastrointestinal endoscopy, to exclude other conditions, and oesophageal manometry, which confirms abnormal oesophageal motility and dysfunction of the lower oesophageal sphincter.

Treatment aims to facilitate the passage of food into the stomach and may include:

• Endoscopic dilatation of the lower oesophageal sphincter;
• Surgical treatment with myotomy;
• Peroral endoscopic myotomy (POEM).

Clinical follow-up is essential to prevent complications such as malnutrition, pulmonary aspiration and progressive worsening of symptoms.