Diseases 
Achalasia
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Achalasia  Lyall A. Gorenstein, MD |
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Achalasia is an esophageal disorder characterized by an irreversible loss of muscle activity in the lower esophagus accompanied by incomplete LES (lower esophageal sphincter) relaxation. Common symptoms include dysphagia (difficulty swallowing), regurgitation, weight loss, coughing, heartburn, and difficulty belching. Patients commonly modify their diet over time to increasing the proportion of soft foods and liquids. Special x-rays show a dilated esophagus with a "bird beak"-like appearance at its junction with the stomach. All treatment options aim to eliminate the obstruction to esophageal emptying caused by the non-relaxing sphincter.
Endoscopic balloon dilation and Botox injection can offer temporary relief, but surgery remains the gold standard treatment for this condition. The operation is commonly known as a Heller myotomy or esophagomyotomy, and it involves cutting the lower esophageal sphincter. It is commonly accompanied by a fundoplication (wrapping the stomach around the lower esophagus) and can often be performed via minimally invasive techniques.
