Erlanger Logo


Achalasia is a rare disorder of the esophagus characterized by impaired ability to push food down toward the stomach and a failure of the lower esophageal sphincter (the ring-shaped muscle at the bottom of the esophagus) to relax.


  • Trouble Swallowing (Dysphagia)
  • Excessive Weight Loss
  • Regurgitation
  • Chest pain

Risk Factors

  • Genetic disposition and family history
  • Immune system problems
  • Presence of herpes simplex virus or other viral infections.
  • Chagas disease (a parasitic infection)


  • Physical exam and health history – Exam of the body to check general signs of health, and a look at your generaly health history.
  • Endoscopy - A nonsurgical procedure to examine a patient’s digestive tract.
  • Esophageal Manometry - Test that measures the rhythmic muscle contractions in your esophagus.


Treatment aims to relax or stretch open the patient’s lower esophageal sphincter, allowing foods and liquid to pass through to the digestive system more easily.

Nonsurgical approaches

  • Pneumatic dilation – Your provider endoscopically inserts a balloon into the center of the esophageal sphincter and inflates it to enlarge the opening.
  • Botox (botulinum toxin type A) – Your provider injects a muscle relaxant into the esophageal sphincter with an endoscopic needle.
  • Medications – Muscle relaxing medications are sometimes prescribed, but usually only if the patient is not a candidate for other surgical and non-surgical approaches.

Surgical approaches

  • Heller Myotomy - The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach.
  • Peroral Endoscopic Myotomy (POEM) - In the POEM procedure, the surgeon uses an endoscope inserted through your mouth and down your throat to create an incision in the inside lining of your esophagus.

This content was last medically reviewed in May 2022 by Sharlotte Manley, MSN, FNP, Erlanger Gastroenterology.