Achalasia Cardia

Achalasia cardia is an uncommon neuromuscular condition affecting the esophagus, where the lower esophageal sphincter (LES) does not relax properly and the esophageal muscles lose coordinated peristalsis. This prevents food and liquids from passing smoothly into the stomach, leading to progressive dysphagia for both solids and liquids.

Typical symptoms include regurgitation of undigested food, chest pain or discomfort, heartburn?like burning, and sometimes chronic cough or aspiration, especially at night. Over time, the esophagus may dilate (“mega?esophagus”) as contents accumulate, increasing the risk of pneumonia and significant weight loss.

Diagnosis usually requires barium swallow, endoscopy, and high?resolution esophageal manometry to confirm absent peristalsis and failed LES relaxation. Treatment aims to relieve obstruction and improve swallowing, using options such as pneumatic balloon dilation, laparoscopic Heller myotomy, or peroral endoscopic myotomy (POEM). Early intervention helps preserve esophageal function and markedly improves patients’ quality of life.