Achalasia Awareness Month 2022

September is achalasia awareness month. Achalasia is a condition that affects the nerves and muscles of the oesophagus (food pipe), mainly at the lower end where it meets the stomach. Achalasia hinders the passage of food and fluid down the oesophagus and entering the stomach. This results in difficulty swallowing.

What are the most common symptoms of achalasia?

The most common is difficulty swallowing (dysphagia) that occurs with both food and liquids.

Other symptoms can include:

• Food may feel as if it is stuck in the oesophagus after eating, causing chest discomfort or pain.
• Regurgitation of food (bringing food back up). This may occur as food is retained in the oesophagus and has nowhere to go except upwards.
• This can cause choking or coughing. This may lead to chest infections if the food goes back down the wrong way and into the lungs.
• As a result of food not passing into the stomach and difficulty swallowing, less food is ingested and it is common to lose weight.
• Sometimes, no symptoms are experienced and the condition is diagnosed incidentally during tests for a different condition.

These symptoms may be present for months or even years before people seek help. As well, because of the non-specific nature of symptoms and the relative rarity of achalasia this means there can be a delay in diagnosis.

How can achalasia affect you?

Achalasia can have an impact on people’s general well-being from the symptoms. People can struggle to keep weight on and it can lead to poor nutrition. Meaning if you are unable to maintain a healthy weight and become malnourished, other feeding methods may be needed.

Another way achalasia can affect you is because of the complications from the actual condition. These are both very rare and include:

• Mega-oesophagus: this is where over a long period of time the oesophagus continues to dilate until it becomes severely enlarged. The muscles then cannot stretch anymore, sometimes causing the oesophagus to tear or burst.
• Cancer of the oesophagus: achalasia can very rarely be associated with this cancer. Although highly unusual it is one of the reasons you should remain under outpatient follow up with a specialist.

James’s Achalasia Story

James first noticed something wasn’t quite right on his birthday, when he struggled to finish his burger and started to feel sick. He then started to experience a ‘strange chest pain’ and called 111.

James had several phone consultations after this with his doctor. Because James’s symptoms started during a lockdown NHS services were delayed and no one saw him face to face to see how much weight he was losing. It took James 5 months to be diagnosed with achalasia.

“I found these 5 months frustrating. I was hungry, tired, and fed up. I just wanted to eat normally again. The only thing I didn’t struggle to eat was jelly babies.” – James.