Achalasia Awareness Month 2023

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 interrupts food and fluid travelling down the oesophagus and entering the stomach.

What are the most common symptoms of achalasia?

The most common symptom 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.

How does achalasia behave over time?

Unfortunately, there is no cure for achalasia. However, some patients will achieve reasonable symptom control with treatment although a small number of patients may have ongoing symptoms despite treatment. Continue reading to discover stem cell research previously funded by Guts UK.

Dannii’s achalasia story

Dannii was 18 years old when she first noticed symptoms, after swallowing rice. She noticed it was stuck in her throat and also experienced reflux and pains in her chest. Her symptoms showed gradually over a couple of months but she first ignored them. This was because she had won a scholarship to the FA National England player development centre and didn’t want to be deemed “unfit” for selection.

However, her symptoms continued to the point where it took her over an hour to finish a meal and she experienced other symptoms such as weight loss and struggling to stay hydrated. After speaking to her doctor, it took a full year for Dannii to get diagnosed with achalasia.

“I struggled in the early days to describe my symptoms. I remember the turning point being when I described it as a ‘functional problem.’ My food wasn’t going into my stomach. He (my consultant) decided to send me for a barium swallow test, where I was finally diagnosed with achalasia.”  ” –Dannii.