Pathology of the Gastrointestinal Tract

2017 Edition
| Editors: Fátima Carneiro, Paula Chaves, Arzu Ensari

Achalasia, Esophagus

  • Luis Novais
  • Paula Chaves
Reference work entry


Primary achalasia


Achalasia is an esophageal disorder of unknown cause characterized by aperistalsis of esophagus body and impaired relaxation of the lower esophageal sphincter (LES).

The most common symptoms for achalasia presentation are dysphagia, regurgitation, weight loss, chest pain, and pulmonary symptoms such as cough. The dysphagia to solids is present in nearly all achalasia patients and to liquids present in two-thirds of patients. The onset of the dysphagia is usually gradual; initially, the dysphagia may be primarily for solids; however, by the time of clinical presentation, nearly all patients complain of dysphagia for solids and liquids while eating and drinking, especially cold beverages. Regurgitation is found in 60–90% of achalasia patients. It usually occurs shortly after a meal or while recumbent. Undigested food is regurgitated. Chest pain is found in one-third of achalasia patients. It is retrosternal and is typical of noncardiac chest pain....

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References and Further Reading

  1. Boeckxstaens, G. E., Annese, V., des Varannes, S. B., et al. (2010). The European achalasia trial: A randomized multi-centre trial comparing endoscopic pneumodilation and laparoscopic myotomy as primary treatment of idiopathic achalasia. Gastroenterology, 138(Suppl. 1), S53.Google Scholar
  2. Bredenoord, A. J., Fox, M., Kahrilas, P. J., Pandolfino, J. E., Schizer, W., Smouth, A. J. P. M., & The International High Resolution Manometry Working Group. (2012). Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography. Neurogastroenterology and Motility, 24(Suppl 1), 57–65.PubMedPubMedCentralGoogle Scholar
  3. Eckardt, A. J., & Eckardt, V. F. (2009). Current clinical approach to achalasia. World Journal of Gastroenterology, 15, 3969–3975.PubMedPubMedCentralGoogle Scholar
  4. Pandolfino, J. E., Kwiatek, M. A., Nealis, T., Bulsiewicz, W., Post, J., & Kahrilas, P. J. (2008). Achalasia: A new clinically relevant classification by high-resolution manometry. Gastroenterology, 135, 1526–1533.PubMedPubMedCentralGoogle Scholar
  5. Richter, J. E., & Roberts, J. R. (2012). The esophagus. In J. E. Richter, & D. O. Castell (Eds.), Achalasia (5th ed., pp. 257–301). Blackwell Publishing Ltd.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Neurogastroenterology and Gastrointestinal Motility Laboratory, CEDE-Faculty of Medical SciencesNew University of LisbonLisbonPortugal
  2. 2.Serviço de Anatomia PatológicaInstituto Português de Oncologia de Lisboa de Francisco GentilLisbonPortugal
  3. 3.Faculdade de Ciências da SaúdeUniversidade da Beira InteriorCovilhãPortugal