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Achalasia is a condition that affects how the oesophagus (also often called the gullet) works, and causes symptoms related to eating and drinking. The oesophagus is a muscular tube that runs from the back of the throat through the chest into the stomach. When you swallow food or drink, this tube normally contracts (or pushes) what you have swallowed downwards into the stomach. In addition, a small ring of muscle at the bottom of the oesophagus just above the stomach (shown as the gastro-oesophageal junction in the picture below) relaxes to let the food and drink through. In achalasia, the muscles in the oesophagus do not work properly. The ring of muscle at the bottom of the oesophagus does not relax as it should, making it difficult for food and drink to get through into the stomach. In addition, the whole of the oesophagus above this stops contracting (or pushing) in the normal way.

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Image credit: Cancer Research UK Uploader, 2016

Different symptoms that patients with achalasia can experience are explained below.

Difficulty swallowing

Patients often experience difficulty eating and drinking. The medical term for this is dysphagia. This means that food or drink may get stuck on the way down, which can sometimes be felt in the chest behind the breast bone. This can vary day-to-day, so the same food or drink can be more or less of a problem on different days or weeks.

Heartburn or pain

Patients may experience a burning or achy sensation in the middle of the chest behind their breast bone or in the upper part of the abdomen or tummy. Sometimes this can be severe and people report feeling pain in this area. However, this is a very common symptom in people in general, not just people with achalasia, with up to 20% of the population suffering indigestion symptoms each week.

Pain on swallowing

Patients may experience pain in the middle of the chest, behind the breast bone, when they swallow food or drink. The medical term for this is odynophagia. In addition some people may get severe pains from spasms of the oesophagus. Others get milder symptoms that are more like heartburn.

Regurgitation and/or vomiting

Food and drink that gets stuck in the oesophagus and cannot easily enter the stomach may come back up, either as regurgitation or vomiting.

Weight loss

It can be very difficult to eat and drink normal amounts so some people lose weight.