Achalasia is a failure of smooth muscle fibers to relax, which can cause a sphincter to remain closed and fail to open when needed. Achalasia simply refers to achalasia of the esophagus. Esophageal achalasia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter (LES). Sphincter is like a valve that prevents regurgitation of food. Achalasia is characterized by incomplete LES relaxation, increased LES tone, and lack of peristalsis(involuntary movements of the food pipe and intestines) of the esophagus in the absence of other disorders like cancer or fibrosis. The symptoms of Achalasia include difficulty in swallowing, regurgitation, and sometimes chest pain. Diagnosis is reached with esophageal manometry and barium swallow radiographic studies. Various treatments are available, although none cures the condition. Certain medications like Botulinum toxin may be used in some cases, but more permanent relief is brought by esophageal dilatation and surgical cleaving of the muscle (Heller myotomy).
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