Achalasia is a disorder of the muscle (and the nerves that control the muscle) of your lower esophagus that makes it difficult for food and liquid to pass into your stomach. Unlike GERD, the sphincter muscle is in a constant state of contraction causing obstruction with swallowing and subsequent regurgitation.
Tests & Diagnosis
Barium swallow study involves you drinking a chalky liquid (barium solution) that coats your esophagus, allowing us to visualize on X-rays the passage of this fluid through your esophagus and into the stomach.
High-resolution manometry measures the strength, pressure and coordination of your esophagus' muscles. A specially trained nurse guides a small catheter through your nose and into the esophagus and instructs your to swallow small amounts of liquid at specific intervals. This test is required to make the diagnosis of achalasia.
Botox injection is when botulinum toxin A is injected into your gastroesophageal sphincter muscle in order to relax the opening. This provides temporary relief of achalasia symptoms.
Balloon dilation is a procedure that provides relief from achalasia by inflating a balloon inside your esophagus during an upper endoscopy in order to stretch the constricted muscles.
Laparoscopic heller myotomy is a surgical procedure that releases the muscles at the gastroesophageal junction, allowing the valve between the esophagus and stomach to stay open. Performed through small incisions, the muscles are cut (myotomy), and the stomach is wrapped around the esophagus (partial fundoplication) to prevent reflux that may be caused by releasing the valve.
Per-oral endoscopic myotomy (POEM) is an innovative, minimally-invasive surgical approach to treat achalasia in the same way as heller myotomy but without making any incisions in your skin. Physicians instead access your esophagus by inserting an endoscope into your mouth. By eliminating the need for external incisions, we are able to speed your healing process, limit or eliminate pain, and achieve a cosmetically positive result.