Achalasia is a nerve disorder in which the esophagus loses its ability to push food down and the lower valve fails to relax to let food into the stomach. It most often affects young adults aged 20–40 and is frequently misdiagnosed as reflux for years. Treatment is not medical; it involves cutting the valve muscle either through the mouth endoscopically or surgically with the robot.
Common symptoms
- Difficulty swallowing that starts with solids and progresses to liquids
- Regurgitation of undigested food, especially at night
- Unintentional weight loss
- Chest pain and heartburn that do not respond to acid medication
- Night cough or recurrent chest infections from food entering the lungs
When is surgery an option?
Once the diagnosis is confirmed by esophageal manometry, intervention is the only real treatment; delay leads to irreversible dilatation and damage of the esophagus. The choice between per-oral endoscopic myotomy (POEM) and a robotic Heller myotomy with partial fundoplication depends on the achalasia subtype and the patient's age.
Treatment options
- High-resolution esophageal manometry (the gold standard for diagnosis)
- Per-oral endoscopic myotomy (POEM) with no external incision
- Robotic Heller myotomy with partial fundoplication
- Endoscopic dilatation for strictures and robotic removal of benign esophageal tumours
Frequently asked questions
Can achalasia be cured with medication?
No. Medication may ease symptoms temporarily but cannot restore the valve's ability to relax. Effective treatment is myotomy, endoscopic or surgical.
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Dr. Soliman Fakeeh Hospital – Jeddah (Main Branch) · Monday & Thursday, 5:00 – 8:00 PM